title: [Pseudotumoral adenopathies, an unusual means of detecting systemic amyloidosis].
abstract: BACKGROUND
  It is uncommon that lymph node enlargement is diagnostic of systemic amyloidosis as found in the case reported in this study.
  
  
  METHODS
  This study examined the case of a 49-year old male with chronic bronchitis in whom in 1990 the presence had been detected of an isolated cervical lymphadenopathy, 2 cm in diameter, and which had previously remained unnoticed. In 1993, a significant number of other peripheral adenopathies also appeared in various locations, i.e., cervical, axillary, inguinal. Chest and abdominal CT-scans revealed several mediastinal and abdominal lymphadenopathies. The histological study with Congo red stain of a cervical lymph node biopsy determined the diagnosis of amyloidosis. The patient was at that time asymptomatic. In September 1997, upon physical examination the following were found: lower limb edema, superior vena cava syndrome, and several cervical lymphadenopathies. Abdominal ultrasonography showed enlarged kidneys, and homogeneous splenomegaly. Biological examination determined the existence of a nephrotic syndrome with renal failure and creatinemia of 350 mumol/L. Due to superior vena cava syndrome worsening, cervical lymph node removal was performed. However, the patient died after rapid renal failure.
  
  
  CONCLUSIONS
  Although it is a rare occurrence, amyloidosis should be taken into consideration in the differential diagnosis of isolated lymphadenopathy. Congo red stain amongst others, and an immunohistochemical study should be performed in cases of uncertain diagnosis.
authors.affiliation: Service de médecine interne, hôpital La Rabta, Tunis, Tunisie.
authors.forename: I
authors.initials: I
authors.lastname: Ben Ghorbel
authors.forename: M H
authors.initials: MH
authors.lastname: Houman
authors.forename: M
authors.initials: M
authors.lastname: Lamloum
authors.forename: N B
authors.initials: NB
authors.lastname: Romdhane
authors.forename: L
authors.initials: L
authors.lastname: Daniel
authors.forename: B
authors.initials: B
authors.lastname: M'Timet
authors.forename: M
authors.initials: M
authors.lastname: Miled
mesh_terms: D000686:Amyloidosis / Q000175:diagnosis*; D004487:Edema / Q000175:diagnosis; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis; D007866:Leg; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000175:diagnosis; D013163:Splenomegaly / Q000000981:diagnostic imaging; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis; D014463:Ultrasonography
vernacular_title: Adénopathies pseudotumorales, mode exceptionnel de révélation de l'amylose systémique.