[Pseudotumoral mediastinal amyloidosis].
OBJECTIVE
Amyloidosis involvement of mediastinal nodes is rare. Isolated pseudotumoral involvement without extra-thoracic disease is a diagnostic challenge and typically raises concern for underlying malignancy. We present 3 cases of pseudotumoral mediastinal amyloidosis.


METHODS
We report the cases of 3 patients presenting with recent onset of respiratory symptoms. Bronchoscopy showed mucosal infiltration suspicious for lymphangitic spread of tumor. The patients underwent chest radiography complemented by CT of the chest and abdomen, and laboratory and immunological work-up. A diagnosis of pseudotumoral mediastinal amyloidosis was confirmed by mediastinoscopic biopsy in all cases.


RESULTS
CT showed a pulmonary and mediastinal tumor process in 2 cases and pericarinal tumor in 1 case. Diffuse bronchial wall thickening was present in all cases. Review of biopsy material showed tracheobronchial amyloidosis in 1 case. Patient work-up showed no evidence of extra-thoracic amyloidosis. Rapid progression of bronchial obstruction was observed in 1 case.


CONCLUSIONS
The imaging features of mediastinal amyloidosis are non-specific. Pseudotumoral involvement of mediastinal nodes associated with pulmonary amyloidosis accelerates the degree of airway obstruction.
Service d'Imagerie médicale, Hôpital Abderrahmen Mami, Ariana, Tunisie. imene.ridenebenrejeb@rns.tn
I
I
Ridene
A
A
Ayadi
S
S
Hantous-Zannad
A
A
Zidi
H
H
Racil
L
L
Fekih
A
A
Chtourou
I
I
Baccouche
K
K
Ben Miled-M'rad
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis*; D001982:Bronchial Diseases / Q000175:diagnosis; D001999:Bronchoscopy; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis; D008206:Lymphatic Diseases / Q000175:diagnosis*; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis*; D008481:Mediastinoscopy; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000175:diagnosis