title: Systemic AA amyloidosis in a patient with lung metastasis from renal cell carcinoma.
abstract: AA amyloidosis occurs in patients with high levels of serum amyloid A protein (SAA), which is produced by liver cells in response to signals from several pro-inflammatory cytokines. Chronic inflammatory disease is a major cause of AA amyloidosis; however, malignant neoplasms are rarely reported to be associated with AA amyloidosis. We report herein a case of a solitary lung metastasis of renal cell carcinoma associated with systemic AA amyloidosis. Pathological specimens of the resected lung tumor demonstrated renal cell carcinoma, and the presence of IL-1β, IL-6, and TNF-α in the lymphocytes and plasma cells surrounding the tumor cells, and AA amyloid in the vascular area, but not in metastatic clear cells. Four weeks after surgery, serum IL-6, SAA, and CRP levels normalized. Although this case is very rare, it is full of interesting suggestions about the pathogenesis of malignancy-related systemic amyloidosis.
authors.affiliation: Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nobata
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suga
authors.forename: Ayano
authors.initials: A
authors.lastname: Itoh
authors.forename: Naoto
authors.initials: N
authors.lastname: Miura
authors.forename: Wataru
authors.initials: W
authors.lastname: Kitagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morita
authors.forename: Toyoharu
authors.initials: T
authors.lastname: Yokoi
authors.forename: Shogo
authors.initials: S
authors.lastname: Banno
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imai
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D016207:Cytokines / Q000097:blood; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D007680:Kidney Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008175:Lung Neoplasms / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D011859:Radiography; D000685:Serum Amyloid A Protein / Q000378:metabolism*
chemical_list: D016207:Cytokines; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein