Nodular pulmonary amyloidosis is characterized by localized immunoglobulin deposition and is frequently associated with an indolent B-cell lymphoproliferative disorder

Karen L. Grogg, Marie Christine Aubry, Julie A. Vrana, Jason D. Theis, Ahmet Dogan

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Nodular pulmonary amyloidosis, a rare localized form of amyloidosis, has been associated with immunoglobulin light chains (AL type) and variably with low-grade lymphoma. The clinicopathologic features of 18 cases were investigated; 5 of 14 had autoimmune disease. In 14 cases monotypic plasma cells could be demonstrated by immunohistochemistry. By mass spectrometry analysis of the amyloid deposits, all 18 cases showed a peptide profile with an abundance of immunoglobulin light chains (12 κ, 4 λ, and 2 mixed κ and λ), with 13 also showing significant codeposition of heavy chains (10 γ, 2 α, 1 δ). Of 14 patients with follow-up, 3 developed recurrent pulmonary amyloidoma, 2 had pulmonary recurrence plus cutaneous extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type with and without amyloid, and 1 had a history of parotid gland MALT lymphoma. This study highlights the unique features of this localized form of amyloidosis. AL κ type is more frequent than AL λ type, with a ratio of 3:1, in contrast to the AL λ predominance that characterizes systemic AL amyloidosis. In addition, the majority of nodular pulmonary amyloid is of mixed AL/AH type, a rare finding in systemic amyloidosis. The association of nodular pulmonary amyloidoma with autoimmune disease and lymphoma indicate the majority of these lesions relate to an underlying lymphoplasmacytic neoplasm in the spectrum of MALT lymphoma.

Original languageEnglish (US)
Pages (from-to)406-412
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number3
DOIs
StatePublished - Mar 2013

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Lymphoproliferative Disorders
Amyloidosis
Immunoglobulins
B-Lymphocytes
Marginal Zone B-Cell Lymphoma
Lung
Immunoglobulin Light Chains
Amyloid
Autoimmune Diseases
Parotid Gland
Amyloid Plaques
Plasma Cells
Non-Hodgkin's Lymphoma
Lymphoma
Mass Spectrometry
Immunohistochemistry
Recurrence
Skin
Peptides
Neoplasms

Keywords

  • MALT lymphoma
  • nodular pulmonary amyloidosis
  • tandem mass spectrometry

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Nodular pulmonary amyloidosis is characterized by localized immunoglobulin deposition and is frequently associated with an indolent B-cell lymphoproliferative disorder. / Grogg, Karen L.; Aubry, Marie Christine; Vrana, Julie A.; Theis, Jason D.; Dogan, Ahmet.

In: American Journal of Surgical Pathology, Vol. 37, No. 3, 03.2013, p. 406-412.

Research output: Contribution to journalArticle

Grogg, Karen L. ; Aubry, Marie Christine ; Vrana, Julie A. ; Theis, Jason D. ; Dogan, Ahmet. / Nodular pulmonary amyloidosis is characterized by localized immunoglobulin deposition and is frequently associated with an indolent B-cell lymphoproliferative disorder. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 3. pp. 406-412.
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