Nodular Pulmonary Amyloidosis Mimicking Metastatic Malignancy: A Case Report

肺部結節性類澱粉沉著症仿似轉移性惡性病變：病例報告

周翊(Yih Chou) ； 朱遠志(Yuan-Chih Chu) ； 陳芬芬(Fen-Fen Chen) ； 薛尊仁(Tzuen-Ren Hsiue)

《胸腔醫學》 17卷3期 (2002/09) Pp. 276-281

摘要

類澱粉沈著症是於細胞外沈積大量特異，難溶性的蛋白纖維，因而玻壞正常組織結構及功能。類澱粉的沈積可以是局部性或是系統性的，當類澱粉沈積局限於呼吸道時可侵犯咽喉、氣管－支氣管或肺實質。在此我們報告一位67歲家庭主婦主訴咳嗽合併血痰已有一個月的時間。影像檢查包括胸部X光及電腦斷層掃瞄皆呈現兩側多發性結節病灶並傾向分佈於兩側下肺葉—仿似轉移性惡性病變。病理上的發現包括支氣管鏡切片及電腦斷層導引細針肺切片皆未顯示惡性細胞，反而呈現大量無定形物質沈積於細胞外，且在剛果紅染色並以偏光鏡檢查下呈現特異性蘋果綠的顏色，最後診斷為“類澱粉沈著症”而後續的檢查顯示除了呼吸系統外並無其它系統的侵犯。

關鍵字

類澱粉沈著症 ； 肺結節 ； 剛果紅染色 ； 偏光

並列摘要

Amyloidosis is a disorder associated with the extracellular deposition of characteristic insoluble protein fibrils which interfere with tissue structure and function. Amyloidosis may be focal, localized, or systemic. The deposits can be localized in the respiratory tract, especially the larynx, tracheobronchus, and lung parenchyma.
We herein report a case of a 67-year-old female who had suffered from a cough with bloody sputum for a month. The image studies, including chest radiograph and computed tomograph, revealed bilateral multiple nodular lesions with a predilection for the basal lung fields, mimicking metastatic malignancy. Pathological examinations revealed dense pale-pink amorphous deposits and an apple-green color on Congo-red staining viewed under polarized light. Based on the above results, pulmonary amyloidosis was diagnosed. The disease was found to be localized within the respiratory tracts after a series of studies.

並列關鍵字

amyloidosis ； pulmonary nodules ； Congo-red stain ； polarized light