Amyloid-like pulmonary nodules, including localized light-chain deposition: clinicopathologic analysis of three cases

Am J Clin Pathol. 2004 Feb;121(2):200-4. doi: 10.1309/3GEC-PW24-02F6-V8EK.

Abstract

Amyloid-like pulmonary nodules have been described in patients with systemic light-chain deposition disease, but their significance in other clinical contexts is unknown. We examined biopsy specimens of amyloid-like pulmonary nodules from 3 women without systemic light-chain deposition disease. Patient 1 (aged 62 years) had multiple pulmonary nodules and underwent 2 separate lung biopsies, the first showing nodules composed of kappa light-chain deposits accompanied by low-grade lymphoplasmacytic lymphoma limited to the lung and the second, obtained after chemotherapy 9 months later, showing only residual nodules without persistent lymphoma. Patients 2 (aged 65 years) and 3 (aged 69 years) had asymptomatic solitary pulmonary nodules. In all cases, electron microscopic examination showed dense granular extracellular deposits without the fibrillary characteristics of amyloid. Amyloid-like nodules should be distinguished from nodular amyloidosis and, in some patients, might represent a localized form of light-chain deposition.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloid / metabolism
  • Amyloid / ultrastructure
  • Amyloidosis / metabolism
  • Amyloidosis / pathology*
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin kappa-Chains / metabolism*
  • Lung / metabolism
  • Lung / pathology
  • Microscopy, Electron
  • Middle Aged
  • Solitary Pulmonary Nodule / immunology
  • Solitary Pulmonary Nodule / metabolism
  • Solitary Pulmonary Nodule / pathology*

Substances

  • Amyloid
  • Immunoglobulin kappa-Chains