Monoclonality of infiltrating plasma cells in primary pulmonary nodular amyloidosis: detection with polymerase chain reaction.
OBJECTIVE
To investigate the relation between localised amyloidosis and immunocytic dyscrasia.


METHODS
Open lung biopsy specimens from a 72 year old man with multiple nodules in the right middle and lower lung were stained with haematoxylin-eosin, Congo red, and antibodies against IgG, IgA, IgM, and kappa and lambda light chains. Semi-nested PCR amplification for the immunoglobulin heavy chain (IgH) gene was performed using consensus primers for the VDJ region of the IgH gene, FR3A, LJH, and VLJH.


RESULTS
The biopsy specimens contained eosinophilic amorphous material stained with Congro red and anti-kappa light chain, and surrounded by inflammatory cells intermingled with plasma cells. Plasma cells in the adjacent amorphous material showed cytoplasmic staining with anti-kappa. Polymerase chain reaction revealed a discrete amplified band of apparently uniform size with background smear.


CONCLUSIONS
Primary AL type localised amyloidosis involves local accumulation of monoclonal plasma cells and their secreted products, as in nodular cutaneous amyloidosis. Localised AL type nodular amyloidosis is a separate entity in amyloidosis.
Miyamoto
T
T
Department of Dermatology, Tsuyama Central Hospital, Japan.
Kobayashi
T
T
Makiyama
M
M
Kitada
S
S
Fujishima
M
M
Hagari
Y
Y
Mihara
M
M
D000368:Aged; D000686:Amyloidosis / Q000276:immunology / Q000473:pathology*; D002999:Clone Cells; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007150:Immunohistochemistry; D008168:Lung / Q000276:immunology / Q000473:pathology*; D008171:Lung Diseases / Q000276:immunology / Q000473:pathology*; D008297:Male; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology*; D016133:Polymerase Chain Reaction
D007145:Immunoglobulin kappa-Chains