Amyloid-like pulmonary nodules, including localized light-chain deposition: clinicopathologic analysis of three cases.
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.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA.
Andras
A
Khoor
Jeffrey L
JL
Myers
Henry D
HD
Tazelaar
Paul J
PJ
Kurtin
D000368:Aged; D000682:Amyloid / Q000378:metabolism / Q000648:ultrastructure; D000686:Amyloidosis / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007145:Immunoglobulin kappa-Chains / Q000378:metabolism*; D008168:Lung / Q000378:metabolism / Q000473:pathology; D008854:Microscopy, Electron; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000276:immunology / Q000378:metabolism / Q000473:pathology*
D000682:Amyloid; D007145:Immunoglobulin kappa-Chains