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Disappearing Nodules: Spontaneously Regressing Pulmonary Amyloidosis

Glass, L. N. 2019Other/Unknown

Glass, L. N., Sumon, M., Goulart, H., & Ahari, J. (2019). Disappearing nodules: spontaneously regressing pulmonary amyloidosis. BMJ case reports, 12(5), e229718. https://doi.org/10.1136/bcr-2019-229718

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Abstract

A case report of spontaneous regression of pulmonary amyloidosis, diffuse interstitial pattern, in an elderly patient.

Case Details

Disease Location

Lung, lymph nodes

Personal Characteristics

82-year-old woman. History of hypothyroidism, left breast cancer with mastectomy, hypertension, hyperlipidemia, diet-controlled diabetes and gastro-oesophageal reflux disease

Clinical Characteristics

She tripped over a loose brick and suffered a mechanical fall with injury to her left knee. She noticed left-sided chest pain 1 day later without radiation. CT scan demonstrated septal thickening, mediastinal lymphadenopathy, hilar lymphadenopathy, calcified hilar lymph nodes, right hilar hypodensity and innumerable 2–3 mm pulmonary nodules. Transbronchial biopsy of the right upper lobe showed thickened vascular walls and a deposit of amorphous material around the bronchiole. Serum immunofixation identified IGA light chain monoclonal gammopathy. Bone marrow biopsy revealed hypercellular marrow and trilineage haematopoiesis with 5%–10% plasma cells and no evidence of frank myeloma.

Remission Characteristics

On repeat CT imaging 6 months later, a decrease in parenchymal disease was noted

Treatment & Mechanisms

Clinical Treatment

Biopsy