Nodular senile pulmonary amyloidosis: a unique case confirmed by immunohistochemistry, mass spectrometry, and genetic study

Anja Roden, Marie Christine Aubry, Kai Zhang, James O. Brady, David Levin, Ahmet Dogan, Eunhee S. Yi

Research output: Contribution to journalArticle

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Abstract

Nodular pulmonary amyloidosis, characterized by solitary or multiple parenchymal nodules, is primarily composed of amyloid immunoglobulin light chain protein. Pulmonary involvement by senile amyloidosis has been reported as an incidental finding with scattered or diffuse interstitial deposition of amyloid protein transthyretin mostly in patients with cardiac senile amyloidosis in a small number of autopsy cases. We report a unique case of pulmonary senile amyloidosis presenting with conglomerated nodular deposition of amyloid protein transthyretin as the main clinical manifestation. The patient was an 82-year-old man who presented with recurrent pleural effusions and nodular replacement of pulmonary parenchyma on a chest computed tomographic scan. He underwent a wedge resection of the lesion. Histologic examination revealed a massive deposition of Congo red-positive amyloid identified as amyloid protein transthyretin by both immunohistochemistry and mass spectrometry using formalin-fixed, paraffin-embedded tissues. Molecular testing did not show any mutation associated with familial amyloidosis in the TTR gene, further supporting the diagnosis of senile amyloidosis. To our knowledge, this is the first documented case of nodular senile amyloidosis of the lung that was confirmed with the current state-of-the-art methods.

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
JournalHuman Pathology
Volume41
Issue number7
DOIs
StatePublished - Jul 2010

Fingerprint

Amyloidosis
Mass Spectrometry
Immunohistochemistry
Amyloidogenic Proteins
Lung
Prealbumin
Amyloid
Familial Amyloidosis
Immunoglobulin Light Chains
Congo Red
Incidental Findings
Pleural Effusion
Paraffin
Formaldehyde
Autopsy
Thorax
Mutation
Genes
Proteins

Keywords

  • Amyloidosis
  • Immunohistochemistry
  • Mass spectrometry
  • Molecular study
  • Nodular
  • Senile
  • Transthyretin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Nodular senile pulmonary amyloidosis : a unique case confirmed by immunohistochemistry, mass spectrometry, and genetic study. / Roden, Anja; Aubry, Marie Christine; Zhang, Kai; Brady, James O.; Levin, David; Dogan, Ahmet; Yi, Eunhee S.

In: Human Pathology, Vol. 41, No. 7, 07.2010, p. 1040-1045.

Research output: Contribution to journalArticle

Roden, Anja ; Aubry, Marie Christine ; Zhang, Kai ; Brady, James O. ; Levin, David ; Dogan, Ahmet ; Yi, Eunhee S. / Nodular senile pulmonary amyloidosis : a unique case confirmed by immunohistochemistry, mass spectrometry, and genetic study. In: Human Pathology. 2010 ; Vol. 41, No. 7. pp. 1040-1045.
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