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Weekly Chest CasesArchive of Old Cases

Case No : 834 Date 2013-10-21

  • Courtesy of Eun Young Kim, Ho Yun Lee / Samsung Medical Center
  • Age/Sex 55 / F
  • Chief Complaintdry cough(1 month), underlying disease; multiple myeloma
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Diagnosis With Brief Discussion

Diagnosis
Amyloidosis
Radiologic Findings
The serial CT scans show progressive findings of diffuse smooth interlobular septal thickening in both lungs. The 5.23 CT scan show the new finding of peribronchial consolidation with suspicious focal calcification and ground-glass opacity in Rt. middle and both lower lobes.
Differential diagnosis are lymphangitic tumor spread, interstitial edema or storage disease such as Niemann-Pick disease. PET-CT scan didn't show primary malignant site.
Brief Review
Amyloidosis occurs when proteins accumulate in organs such as the heart, kidney, liver, or intestines. There are three major types of amyloidosis: primary, secondary, and hereditary. Each type of amyloidosis is classified by its underlying causes and the type of protein that accumulates in organs.
Multiple myeloma is a cancer of the plasma cells. These cells are an important part of the immune system responsible for the production of antibodies. In multiple myeloma, the plasma cells overproduce one type of abnormal antibody. The overproduction of abnormal antibodies puts myeloma patients at risk for developing amyloidosis.
Not all multiple myeloma patients will develop amyloidosis. It is estimated that 10 to 15 percent of multiple myeloma patients will experience symptoms from the development of amyloidosis during the course of their disease. However, as many as 38 percent of myeloma patients may develop amyloidosis but experience none of its symptoms.
References
1. Ege E et al. Primary pulmonary amyloidosis associated with multiple myeloma. Tuberk Toraks. 2006;54(1);65-70.
2. Chim et al. Pulmonary Interstitial Amyloidosis Complicating Multiple Myeloma. Journal of Clinical Oncology 2008;26(3);504-506
Keywords
Lung, Metabolic and storage lung disesae,

No. of Applicants : 77

▶ Correct Answer : 39/77,  50.6%
  • - G.B.Pant hospital , India shantiranjan sanyal
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - universidad de chile , Chile aguilera enrique
  • - kasturba medical college , India mugil varman
  • - Myongji hospital , Korea (South) Ji Ye Lee
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Kyoto University , Japan Akihiko Sakata
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • - UWO , Canada S Lee
  • - Hopital Bichat , France, Metropolitan Pauline Pradere
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Asan medical center , Korea (South) yoonyoung choi
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - okayama university , Japan takumi sakamoto
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Tokyo Metropolitan Police Hospital , Japan Eisuke Shibata
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - McGill University Health Center , Canada Alexandre Semionov
  • - SNUH , Korea (South) Eui Jin Hwang
  • - Gachon Gil hospital , Korea (South) junhyung Ann
  • - 異⑸ , Korea (South) sooncheul baek
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - Chungbuk University Hospital , Korea (South) Yunhee Jang
  • - CBNUH , Korea (South) jihyung lee
  • - 異⑸ , China ZHANG YING
  • - Kanto Rosai Hospital , Japan Takana Yamakawa
  • - chungbuk national university hospital , Korea (South) jeehye kim
  • - GHOL, Hopital de Nyon , Switzerland Benoit Rizk
  • - CAC Rennes , France nicolas gautier
  • - McGill university , Canada Badriya Al-Qassabi
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - Government Medical College, Nagpur, India , India Krishna Prasad Bellam
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Kobe City Medical Center General Hospital , Japan Yasuhisa Kurata
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
▶ Correct Answer as Differential Diagnosis : 10/77,  13.0%
  • - University of Tsukuba Hospital , Japan Sodai Hoshiai
  • - University of British Columbia , Canada Amr Ajlan
  • - Avrasya Hospital , Turkey Murat Ulusoy
  • - CHU Poitiers , France CHAN paul
  • - GHICL , France manuel toledano
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Niigata University , Japan Atsushi Uehara
  • - NASA SCANS , India RAKESH BHATIA
  • - IRSA La Rochelle , France Denis Chabassiere
  • - Tokyo Metropolitan Police Hospital , Japan Akifumi Hagiwara
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