Pulmonary AL- amyloidosis masquerading as lung malignancy in an Australian Indigenous patient with Sjogren's syndrome

Subash Heraganahally; Madeline Digges; Madeleine Haygarth; Kosala Liyanaarachchi; Akash Kalro; Sumit Mehra

doi:10.1016/j.rmcr.2018.11.015

Pulmonary AL- amyloidosis masquerading as lung malignancy in an Australian Indigenous patient with Sjogren's syndrome

Respir Med Case Rep. 2018 Nov 22:26:94-97. doi: 10.1016/j.rmcr.2018.11.015. eCollection 2019.

Authors

Subash Heraganahally^{1

2}, Madeline Digges^{1

2}, Madeleine Haygarth¹, Kosala Liyanaarachchi³, Akash Kalro⁴, Sumit Mehra⁵

Affiliations

¹ Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Australia.
² Flinders University, Adelaide, South Australia, Australia.
³ Department of Anatomical Pathology, Royal Darwin Hospital, Darwin, Australia.
⁴ Department of Haematology, Royal Darwin Hospital, Darwin, Australia.
⁵ Department of Respiratory and Sleep Medicine, Flinders Medical centre and Flinders University, Adelaide, South Australia, Australia.

Abstract

Amyloidosis is a heterogeneous group of disorders characterized by misfolding of extracellular proteins. Pulmonary amyloidosis secondary to Sjogren's syndrome (SS) is rare and to the best our knowledge has not been described in indigenous population. There is also minimal information on its clinical and radiological features. We' describe here 52-year-old Australian Indigenous women with underlying Sjogren's syndrome who was initially suspected to have a metastatic lung cancer with FGD avid lung nodule on PET scan. However, wedge resection of the nodule demonstrated eosinophilic homogenous material that demonstrated apple-green birefringence under polarized light after staining with Congo red with immunohistochemistry pattern in keeping with AL amyloidosis.

Keywords: Amyloidosis; Indigenous; Lung nodule; Pulmonary cysts; Sjogren's syndrome.

Publication types

Case Reports