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Weekly Chest CasesArchive of Old Cases

Case No : 277 Date 2003-02-15

  • Courtesy of Chin A Yi, M.D. Tae Sung Kim, M.D., Kyung Soo Lee, M.D. / Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • Age/Sex 53 / M
  • Chief ComplaintCough and sputum for 5 months
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Amyloidosis (Nodular Form)
Radiologic Findings
Multiple discrete nodules were scattered in the right lung. A nodule in RUL was densely calcified and two small nodules in RLL contained punctate foci of calcifications. VATS biopsy was done for uncalcified nodule in RML to exclude the possibility of lung cancer. Nodular Amyloidosis was confirmed by disclosing amorphous pinkish deposits with Congo-red staining.
Brief Review
The term Amyloidosis refers to a group of conditions characterized by extracellular deposition of abnormal protein. It can be classified in primary systemic amyloidosis (64%), localized amyloidosis (31%), and secondary systemic amyloidosis (5%). The main manifestations of localized amyloidosis consisted of single or multiple discrete nodules or masses (nodular amyloidosis), 20% of which had foci of calcification, and thickening of the larynx, trachea, or bronchus (tracheobronchial amyloidosis).
References
1. Utz JP, Swensen SJ, Gertz MA. Pulmonary amyloidosis: the Mayo Clinic experience from 1980 to 1993. Ann Intern Med 1996; 124:407-413.
2. Pickford HA, Swensen SJ, Utz JP. Thoracic cross-sectional imaging of amyloidosis. AJR 1997; 168:351-355.
3. Kim HY, Im JG, Song KS, et al. Localized amyloidosis of the respiratory system: CT features. J Comput Assist Tomogr 1999; 23: 627-631
Keywords
Lung, Metabolic and storage lung disesae,

No. of Applicants : 15

▶ Correct Answer : 4/15,  26.7%
  • - Annecy Hospital, France Gilles Genin
  • - CHU Nancy-Brabois, France Denis Regent
  • - Ewha Womans' University Mokdong Hospital, Korea Yookyung Kim
  • - Hangang Sacred Heart Hospital, Korea Eil Seong Lee
▶ Semi-Correct Answer : 11/15,  73.3%
  • - CHU Grenoble, France Mathieu Rodiere
  • - Chung Li Ten-Chen Hospital,Taiwan Gui-Lin Zheng
  • - Chungju Hospital Konkuk University, Korea Chang Hee Lee
  • - Hanyang University Hospital, Korea Seunghun Lee
  • - MH, Agra, India Rajiv Kapur
  • - Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
  • - Ospedale di Jesi, Italy Giancarlo Passarini
  • - Social Security Hospital, Ankara, Turkey Meric Tuzun
  • - SUN Hospital, Uiwang City, Korea Ki Taek Hong
  • - Teleradiology Solutions, Bangalore, India Sharad Bidari
  • - Tokyo Kouseinenkin Hospital , Japan Noriatsu Ichiba
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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