Respiratory Medicine Case Reports (Jan 2023)

Isolated pulmonary amyloidoma: A rare cause of solitary pulmonary nodule

  • Danielle DeCicco,
  • Esra Alshaikhnassir,
  • Vishal Deepak,
  • Sarah Hadique,
  • Rahul Sangani

Journal volume & issue
Vol. 42
p. 101820

Abstract

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Pulmonary nodules are a frequent finding on imaging, especially given screening guidelines for lung cancer with low dose computed tomography (CT) scan. Here, we report a case with a single pulmonary nodule in a patient exposed to coal dust and asbestos. The nodule had benign features, but it showed an increase in size on repeated imaging. A CT-guided biopsy followed by mass spectrometry of the sample identified the nodule as the AL subtype of amyloidoma. A bone marrow biopsy was without evidence for malignancy including lymphoma. Nodular pulmonary amyloidosis (NPA) is rare, and a biopsy is required to establish the diagnosis. NPA generally does not affect lung function or impact survival; thus NPA does not require specific therapy. This case is the first documented case associated with coal-dust exposure. High-risk patients need to be followed longitudinally due to association of amyloidosis with lymphoma and other systemic conditions.

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