2012 Volume 34 Issue 1 Pages 44-49
Background. Tracheobronchial amyloidosis is a rare disease showing nonspecific respiratory symptoms, so that it is not easy to distinguish it from other respiratory disorders. Case. A 71-year-old man had been treated for bronchial asthma since his forties. He was admitted to our hospital because of cholecystitis, and cholecystectomy was performed under general anesthesia. Since post-surgical ventilatory support could not be withdrawn, he was referred to our department. Review of computed tomography of the chest, which was taken at the time of admission in order to rule out the possibility of dissecting aortic aneurysm, demonstrated irregularly thickened tracheobronchial walls accompanied by calcification. Bronchoscopy revealed multiple elevated lesions in the tracheobronchial walls, and biopsy of the lesion revealed submucosal deposition of AL-type amyloid. Since there were no signs of amyloid deposition in other organs, or of multiple myeloma, we diagnosed tracheobronchial amyloidosis. Conclusion. When computed tomography of the chest reveals abnormalities of the airway wall, even in cases previously diagnosed as bronchial asthma, it is important to rule out other diseases including amyloidosis by performing bronchoscopy.
