Primary Systemic Amyloidosis with Calcified Hilar and Mediastinal Lymphadenopathies Diagnosed by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Specimens

Abstract

Background. Amyloidosis is an unusual cause of mediastinal lymphadenopathy. Recently, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be effective for the assessment of intrathoracic lymphadenopathy. However, there have been few reports regarding the usefulness of EBUS-TBNA for diagnosis of amyloidosis. Case. A 71-year-old man was referred to us for evaluation of hilar and mediastinal lymphadenopathy with calcification. There were no diffuse interstitial changes in the lungs. A histological analysis of the mediastinal lymph node (#7) using EBUS-TBNA demonstrated amyloid deposits. A systemic workup revealed cardiac and gastrointestinal amyloidosis. A diagnosis of primary systemic amyloidosis was made. Conclusion. Amyloidosis should be considered in the differential diagnosis of hilar and mediastinal lymphadenopathy, especially if calcification is present. EBUS-TBNA can be a useful tool for the diagnosis of amyloidosis with mediastinal lymphadenopathy.