title: Nodular pulmonary amyloidosis with spontaneous fatal blood aspiration.
abstract: Amyloidosis is a multisystem disease, which is characterized by the extracellular deposition of insoluble abnormal fibrils. Histological and subsequent immunohistochemical examinations are necessary for the determination of the diagnosis and the classification of the amyloid type. The most common systemic variant is immunoglobulin-derived light chain (AL) amyloidosis. However, local or organ-limited AL amyloidosis can occur. Isolated pulmonary amyloidosis is a rare condition and frequently an incidental finding at chest scans or during autopsy. Generally, it is associated with a benign prognosis. Here, we present two fatal cases, in which the cause of death was asphyxiation due to severe blood aspiration. During autopsy, several nodules were found in the lungs. Based on histological and immunohistochemical analysis, the diagnosis of an isolated nodular pulmonary AL amyloidosis lambda light chain was made. Amyloid was also present in pulmonary blood vessels, which lead to fragility and finally fatal hemorrhage.
authors.affiliation: Institute of Legal Medicine, University Hospital Jena, Friedrich-Schiller-University of Jena, Jena, Germany. Electronic address: Sylvia.Morgenthal@gmx.de.
authors.forename: S
authors.initials: S
authors.lastname: Morgenthal
authors.affiliation: Institute of Legal Medicine, Medical Faculty, University of Leipzig, Leipzig, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Bayer
authors.affiliation: Department of Pathology, Group Practice, Leipzig, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schneider
authors.affiliation: Department of Internal Medicine, Helios Park-Klinikum Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Zachäus
authors.affiliation: Department of Pathology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Röcken
authors.affiliation: Institute of Legal Medicine, Medical Faculty, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Dreßler
authors.affiliation: Institute of Legal Medicine, Medical Faculty, University of Leipzig, Leipzig, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Ondruschka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000150:complications / Q000473:pathology*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000473:pathology*; D008297:Male; D053120:Respiratory Aspiration / Q000209:etiology* / Q000473:pathology
keywords: Blood aspiration; Fatal hemorrhage; Localized amyloidosis; Nodular pulmonary amyloidosis