title: Waldenström's macroglobulinemia accompanying systemic amyloidosis: the usefulness of endobronchial ultrasound-guided transbronchial needle aspiration for detecting amyloid deposits.
abstract: A 75-year-old man with a history of dyspnea lasting for three years presented to our hospital. Chest computed tomography showed bilateral pulmonary nodules, some of which were calcified, in addition to mediastinal/hilar lymphadenopathy and bilateral pleural effusions. Endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) of the subcarinal lymph nodes showed amorphous acellular material compatible with λ-light chain amyloid deposits. Sternal bone marrow aspiration demonstrated increased small lymphocytes admixed with plasma cells and plasmacytoid lymphocytes. Serum immunoglobulin values were decreased with the exception of immunoglobulin M monoclonal peak. We subsequently diagnosed the patient as having Waldenström's macroglobulinemia accompanying AL-type amyloidosis. In this case, EBUS-TBNA was useful for detecting AL-type amyloidosis.
authors.affiliation: Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Noboru
authors.initials: N
authors.lastname: Takayanagi
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Katoh
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Toshiko
authors.initials: T
authors.lastname: Hoshi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sugita
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D001707:Biopsy, Needle; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D058225:Plaque, Amyloid / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D008258:Waldenstrom Macroglobulinemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*