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.

[1]  S. Dacic,et al.  Nodular Amyloidoma and Primary Pulmonary Lymphoma with Amyloid Production: A Differential Diagnostic Problem , 2000, Modern Pathology.

[2]  J. Buxbaum,et al.  Nonamyloidotic monoclonal immunoglobulin deposition disease. Light-chain, heavy-chain, and light- and heavy-chain deposition diseases. , 1999, Hematology/oncology clinics of North America.

[3]  Bernard,et al.  Solitary plasmacytoma of the lung with light chain extracellular deposits: a case report and review of the literature , 1998, Histopathology.

[4]  M. Stokes,et al.  Nodular pulmonary immunoglobulin light chain deposits with coexistent amyloid and nonamyloid features in an HIV-infected patient. , 1997, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[5]  F. Askin,et al.  Katzenstein and Askin's surgical pathology of non-neoplastic lung disease , 1997 .

[6]  H. Kato,et al.  Tracheobronchial AL amyloidosis: histologic, immunohistochemical, ultrastructural, and immunoelectron microscopic observations. , 1993, Human pathology.

[7]  M. Elghetany,et al.  Methods for staining amyloid in tissues: a review. , 1988, Stain technology.

[8]  S. Yousem,et al.  Systemic light chain deposition disease presenting as multiple pulmonary nodules. A case report and review of the literature. , 1988, The American journal of surgical pathology.

[9]  A. Gemma,et al.  Plasmacytoma of the lung associated with nodular deposits of immunoglobulin. , 1987, The American journal of surgical pathology.