Isolated pulmonary amyloidoma: A rare cause of solitary pulmonary nodule

Danielle DeCicco; Esra Alshaikhnassir; Vishal Deepak; Sarah Hadique; Rahul Sangani

doi:10.1016/j.rmcr.2023.101820

Isolated pulmonary amyloidoma: A rare cause of solitary pulmonary nodule

Respir Med Case Rep. 2023 Feb 19:42:101820. doi: 10.1016/j.rmcr.2023.101820. eCollection 2023.

Authors

Danielle DeCicco¹, Esra Alshaikhnassir², Vishal Deepak³, Sarah Hadique³, Rahul Sangani³

Affiliations

¹ Department of Medicine, West Virginia University, Morgantown, WV, 26505, USA.
² Department of Pathology, West Virginia University, Morgantown, WV, 26505, USA.
³ Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, West Virginia University Morgantown, WV, 26505, USA.

Abstract

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.

Keywords: AL protein; Amyloidosis; Benign; CT-Guided biopsy; Lung mass; Lung nodule.

Publication types

Case Reports