Nodular pulmonary amyloidosis diagnosed by ultrasound-guided percutaneous needle biopsy

Yuki Ko; Kazunori Tobino; Yuri Hiramatsu; Takuto Sueyasu; Saori Nishizawa; Yuki Yoshimatsu

Respiratory Medicine Case Reports (Jan 2024)

Nodular pulmonary amyloidosis diagnosed by ultrasound-guided percutaneous needle biopsy

Yuki Ko,
Kazunori Tobino,
Yuri Hiramatsu,
Takuto Sueyasu,
Saori Nishizawa,
Yuki Yoshimatsu

Affiliations

Yuki Ko: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan; Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan; Corresponding author. Department of Respiratory Medicine, Iizuka Hospital; 3-83 Yoshiomachi; Iizuka, Fukuoka, 820-8505, Japan.
Kazunori Tobino: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan; Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
Yuri Hiramatsu: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan
Takuto Sueyasu: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan; Department of Respiratory Medicine, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
Saori Nishizawa: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan
Yuki Yoshimatsu: Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan

Journal volume & issue: Vol. 50
p. 102025

Abstract

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Pulmonary amyloidosis is characterized by extracellular deposition of fibrous protein called amyloid in the lungs and has three subtypes: nodular, diffuse, and tracheobronchial amyloidosis. Pulmonary nodular amyloidosis can mimic other lung diseases including infectious diseases, metastatic lung tumors, sarcoidosis, and pulmonary hyalinizing granuloma. A biopsy of the lesion is essential for a definitive diagnosis. Herein, we report the case of a 66-year-old man who presented for shortness of breath on exertion and was diagnosed with nodular pulmonary amyloidosis on ultrasound-guided percutaneous needle biopsy. A chest X-ray and computed tomography (CT) revealed bilateral slowly growing multiple calcified pulmonary nodules and cavities. Malignancy was suspected based on 18F-fluoro-deoxyglucose (18F-FDG) positron emission tomography/CT (PET/CT) images. An ultrasound-guided percutaneous needle biopsy was performed, and histopathologic examination of the lesion confirmed nodular pulmonary amyloidosis. This case highlights the importance of considering nodular pulmonary amyloidosis in the differential diagnosis of pulmonary nodules with increased uptake of 18F-FDG on PET/CT and the utility of ultrasound-guided needle biopsy in the definitive diagnosis.

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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