1991 Volume 13 Issue 2 Pages 152-158
A 72-year-old female was admitted for further examination of an abnormal chest shadow. She had been treated for rheumatoid arthritis for 10 years. Chest X-ray film on admission showed a solitary nodular shadow in right S^7b. Thoracic CT demonstrated a round tumor with central calcification in right S^7b and tumor with calcification at the posterior wall of the left main bronchus. Bronchoscopic findings showed a nodular lesion with capillary dilatations at the posterior wall of the left main bronchus. Microscopic findings of biopsied specimen from the tumors both in right S^7b and in the left main bronchus showed amyloid deposition. The amyloid in this case stained positively with Congo- red after potassium permanganate treatment, and weakly stained with anti-light chain λ type antiserum by the PAP method. Consequently, this amyloid was interpreted as being composed of AL protein λ type. It seemed that rheumatoid arthritis in this case was not directly associated with amyloidosis. This case corresponded with localized bronchopulmonary amyloidosis may be very rare in Japan. If the enlarged amyloid nodule obstructs the left main bronchus in the near furture, laser therapy may be the first choice of therapy.
