Kumar Gaurav1, Mukta Panda. 1. Department of Medicine, University of Tennessee, College of Medicine-Chattanooga Unit, 975 East Third St., P.O. Box 94, Chattanooga, Tennessee 37403, USA. doctorkumargaurav@yahoo.com
Abstract
BACKGROUND: Dyspnea caused by pulmonary disease is a common symptom encountered by internists. The most likely diagnosis of pulmonary nodules in a long-term smoker is lung cancer. PATIENT/PARTICIPANT: We report a case of an elderly male with a 70-pack-year smoking history, presenting with exertional dyspnea for 6 months. INTERVENTIONS: Detailed review of history was negative. Examination was normal except for diminished breath sounds in all lung fields. Chest x-ray showed bilateral nodular opacities. Computed tomography of thorax revealed multiple bilateral lung masses. A whole-body positron emission tomography revealed enhancement only of the pulmonary masses. Bronchoalveolar lavage was negative for acid fast bacilli, nocardia, and fungi. MAIN RESULTS: Lung biopsy showed findings consistent with amyloidosis. Bone marrow biopsy done to investigate primary amyloidosis showed no clonal plasma cells or amyloid staining, thus suggesting a diagnosis of localized pulmonary amyloidosis. Patient is being managed conservatively with close follow-up for signs of progression.
BACKGROUND:Dyspnea caused by pulmonary disease is a common symptom encountered by internists. The most likely diagnosis of pulmonary nodules in a long-term smoker is lung cancer. PATIENT/PARTICIPANT: We report a case of an elderly male with a 70-pack-year smoking history, presenting with exertional dyspnea for 6 months. INTERVENTIONS: Detailed review of history was negative. Examination was normal except for diminished breath sounds in all lung fields. Chest x-ray showed bilateral nodular opacities. Computed tomography of thorax revealed multiple bilateral lung masses. A whole-body positron emission tomography revealed enhancement only of the pulmonary masses. Bronchoalveolar lavage was negative for acid fast bacilli, nocardia, and fungi. MAIN RESULTS: Lung biopsy showed findings consistent with amyloidosis. Bone marrow biopsy done to investigate primary amyloidosis showed no clonal plasma cells or amyloid staining, thus suggesting a diagnosis of localized pulmonary amyloidosis. Patient is being managed conservatively with close follow-up for signs of progression.
Authors: P A Wingo; L A Ries; G A Giovino; D S Miller; H M Rosenberg; D R Shopland; M J Thun; B K Edwards Journal: J Natl Cancer Inst Date: 1999-04-21 Impact factor: 13.506
Authors: M B Pepys; J Herbert; W L Hutchinson; G A Tennent; H J Lachmann; J R Gallimore; L B Lovat; T Bartfai; A Alanine; C Hertel; T Hoffmann; R Jakob-Roetne; R D Norcross; J A Kemp; K Yamamura; M Suzuki; G W Taylor; S Murray; D Thompson; A Purvis; S Kolstoe; S P Wood; P N Hawkins Journal: Nature Date: 2002-05-16 Impact factor: 49.962