Preview

PULMONOLOGIYA

Advanced search

Pulmonary amyloidosis

https://doi.org/10.18093/0869-0189-2018-28-1-75-83

Abstract

Amyloidosis is an orphan disease. Amyloidosis is uncommonly associated with respiratory disorders. The present article is a review of recently published data on pulmonary amyloidosis and a case report of alveolar and septal amyloid lung injury. Clinical heterogeneity of lung lesions in systemic and limited AL amyloidosis (precursor proteins are light chains of immunoglobulins, λ dimer and κ monomer), AA amyloidosis (inflammatory acute-phase proteins), and ATTR amyloidosis (senile and inherited amyloidosis; precursor protein is transthyretin) have been discussed. One chart of the review has been devoted to the pathogenesis of diffuse parenchymatous (unilateral and bilateral) amyloidosis, nodular and tracheobronchial amyloidosis (with amyloid deposits in proximal, medium and distal airways, intrathoracic lymph node involvement (amyloid lymphadenopathy), amyloidosis of the pleura and the diaphragm, and differential diagnosis of these types of pulmonary amyloidosis.

About the Authors

A. Yu. Tret'yakov
Federal Belgorod National Research University.
Russian Federation

Andrey Yu. Tret'yakov, Doctor of Medicine, Professor, Medical Institute.

ul. Pobedy 85, Belgorod, 308015.



S. P. Zakharchenko
Federal Belgorod National Research University.
Russian Federation

Svetlana P. Zakharchenko, Candidate of Medicine, Senior Researcher, Medical Institute.

ul. Pobedy 85, Belgorod, 308015.



V. A. Tret'yakova
The Peoples' Friendship University of Russia.
Russian Federation

Viktoriya A. Tret'yakova, Resident Physician, Department of Internal Medicine with the Course of Cardiology and Functional Diagnosis.

ul. Miklukho-Maklaya 6, Moscow, 117198.



References

1. Rameev V.V., Kozlovskaya L.V. Amyloidosis: Current methods for diagnosis and treatment. Effektivnaya farmakoterapiya. 2012; (44): 6–15 (in Russian).

2. Pinney J.H., Smith C.J., Taube J.B. et al. Systemic amyloidosis in England: an epidemiological study. Br. J. Haematol. 2013; 161 (4): 525–532. DOI: 10.1111/bjh.12286.

3. Lysenko L.V., Rameev V.V. Diagnosis and Treatment of AA and AL Amyloidosis. National Guideline. Moscow; 2014. Available at: https://freedocs.xyz/view-docs.php?pdf=456688967 (in Russian).

4. Urban B.A., Fishman E.K., Goldman S.M. et al. CT evaluation of amyloidosis: spectrum of disease. Radiographics. 1993; 13 (6): 1295–1308. DOI: 10.1148/radiographics.13.6.8290725.

5. Brown K., Mund D.F., Aberle D.R. et al. Intrathoracic calcifications: radiographic features and differential diagnoses. Radiographics. 1994; 14 (6): 1247–1261. DOI: 10.1148/radiographics.14.6.7855339.

6. Smith R.R., Hutchins G.M., Moore G.W., Humphrey RL. Type and distribution of pulmonary parenchymal and vascular amyloid. Correlation with cardiac amyloidosis. Am. J. Med. 1979; 66 (1): 96–104. DOI: 10.1016/0002-9343(79)90488-1.

7. Scala R., Maccari U., Madioni C. et al. Amyloidosis involving the respiratory system: 5-ear's experience of a multi-disciplinary group's activity. Ann. Thorac. Med. 2015; 10 (3): 212–216. DOI: 10.4103/1817-1737.157290.

8. Sipe J.D., Benson M.D., Buxbaum J.N. et al. Amyloid fibril proteins and amyloidosis: chemical identification and clinical classification International Society of Amyloidosis 2016 Nomenclature Guidelines. Amyloid. 2016; 23 (4): 209–213. DOI: 10.1080/13506129.2016.1257986.

9. Mukhin N.A., ed. Nephrology. National Guideline. Moscow: GEOTAR-Media; 2009 (in Russian).

10. Merlini G., Westermark P. The systemic amyloidoses: clearer understanding of the molecular mechanisms offers hope for more effective therapies. J. Int. Med. 2004; 255 (2): 159–178. DOI: 10.1046/j.1365-2796.2003.01262.x.

11. Merlini G., Seldin D.C., Gertz M.A. Amyloidosis: pathogenesis and new therapeutic options. J. Clin. Oncol. 2011; 29 (14): 1924–1933. DOI: 10.1200/jco.2010.32.2271.

12. Thompson P.J., Citron K.M. Amyloid and lower respiratory the tract. Thorax. 1983; 38 (2): 84–87.

13. Hui A.N., Koss M.N., Hochholzer L., Wehunt W.D. Amyloidosis presenting in the lower respiratory tract. Clinicopathologic, radiologic, immunohistochemical, and histochemical studies on 48 cases. Arch. Pathol. Lab. Med. 1986; 110 (3): 212–218.

14. Müller A.M., Geibel A., Neumann H.P.H. et al. Primary (AL) amyloidosis in plasma cell disorders. Oncologist. 2006; 11 (7): 824–830. DOI: 10.1634/theoncologist.11-7-824.

15. Bahlis N.J., Lazarus H.M. Multiple myeloma-associated AL amyloidosis: is a distinctive therapeutic approach warranted? Bone Marrow Transplant. 2006; 38 (1): 7–15. DOI: 10.1038/sj.bmt.1705395.

16. Dinner S., Witteles W., Witteles R. et al. The prognostic value of diagnosing concurrent multiple myeloma in immunoglobulin light chain amyloidosis. Br. J. Haematol. 2013; 161 (3): 367–372. DOI: 10.1111/bjh.12269.

17. Falk R.H. AL amyloidosis or multiple myeloma? An important distinction. Br. J. Haematol. 2014; 164 (5): 748–749. DOI: 10.1111/bjh.12677.

18. Merlini G., Palladini G. Differential diagnosis of monoclonal gammopathy of undetermined significance. Hematology Am. Soc. Hematol. Educ. Program. 2012; 2012: 595–603. DOI: 10.1182/asheducation-2012.1.595.

19. Kyle R.A., Therneau T.M., Rajkumar S.V. et al. Long-term follow-up of 241 patients with monoclonal gammopathy of undetermined significance: the original Mayo Clinic series 25 years later. Mayo Clin. Proc. 2004; 79 (7): 859–866. DOI: 10.4065/79.7.859.

20. Kyle R.A., Therneau T.M., Rajkumar S.V. et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N. Eng. J. Med. 2002; 346 (8): 564–569. DOI: 10.1056/nejmoa01133202.

21. Warsame R., Kumar S.K., Gertz M.A. et al. Abnormal FISH in patients with immunoglobulin light chain amyloidosis is a risk factor for cardiac involvement and for death. Blood Cancer J. 2015; 5: e310. DOI: 10.1038/bcj.2015.34.

22. Suzuki K. Diagnosis and treatment of multiple myeloma and AL amyloidosis with focus on improvement of renal lesion. Clin. Exp. Nephrol. 2012; 16 (5): 659–671. DOI: 10.1007/s10157-012-0684-5.

23. Ramirez-Alvarado M., Ward C.J., Huang B.Q. et al. Differences in immunoglobulin light chain species found in urinary exosomes in light chain amyloidosis (Al). PLoS One. 2012; 7 (6): e38061. DOI: 10.1371/journal.pone.0038061.

24. Comenzo R.L., Zhang Y., Martinez C. et al. The tropism of organ involvement in primary systemic amyloidosis: contributions of Ig V(L) germ line gene use and clonal plasma cell burden. Blood. 2001; 98 (3): 714–720. DOI: 10.1182/blood.v98.3.714.

25. Perfetti V., Casarini S., Palladini G. et al. Analysis of Vλ-Jλ expression in plasma cells from primary (AL) amyloidosis and normal bone marrow identifies 3r (λIII) as a new amyloid-associated germline gene segment. Blood. 2002; 100 (3): 948–953. DOI: 10.1182/blood-2002-01-0114.

26. Real de Asúa D., Costa R., Galván J.M. et al. Systemic AA amyloidosis: epidemiology, diagnosis, and management. Clin Epidemiol. 2014; 6: 369–377. DOI: 10.2147/CLEP.S39981.

27. Utz J.P., Swensen, S.J., Gertz M.A. Pulmonary amyloidosis. The Mayo Clinic experience from 1980 to 1993. Ann. Inter. Med. 1996; 124 (4); 407–413.

28. Gillmore J.D., Hawkins P.N. Amyloidosis and the respiratory tract. Thorax. 1999; 54 (5): 444–451.

29. Kunze W.P. Senile pulmonary amyloidosis. Pathol. Res. Pract. 1979; 164 (4): 413–422.

30. Khoor A., Colby T.V. Amyloidosis of the lung. Arch. Pathol. Lab. Med. 2017; 141 (2): 247–254. DOI: 10.5858/arpa.2016-0102-ra.

31. Pitz M.W., Gibson I.W., Johnston J.B. Isolated pulmonary amyloidosis: Case report and review of the literature. Am. J. Hematol. 2006; 81 (3): 212–213. DOI: 10.1002/ajh.20518.

32. Grogg K.L., Aubry M.C., Vrana J.A. et al. Nodular pulmonary amyloidosis is characterized by localized immunoglobulin deposition and is frequently associated with an indolent B-cell lymphoproliferative disorder. Am. J. Surg. Pathol. 2013; 37 (3): 406–412. DOI: 10.1097/PAS.0b013e318272fe19.

33. Wang Q., Chen H., Wang S. Laryngo-tracheobronchial amyloidosis: a case report and review of literature. Int. J. Clin. Exp. Pathol. 2014; 7 (10): 7088–7093.

34. Geusens E.A, Verschakelen J.A, Bogaert J.G. Primary pulmonary amyloidosis as a cause of interlobular septal thickening. Am. J. Roentgenol. 1997; 168: 116–117.

35. Vieira I.G., Marchiori E., Zanetti G. et al. Pulmonary amyloidosis with calcified nodules and masses-a six-year computed tomography follow-up: a case report. Cases J. 2009; 2 (1): 6540. DOI: 10.4076/1757-1626-2-6540.

36. Bril A.K., Woelke K., Schädlich R. et al. Tracheobronchial amyloidosis bronchoscopic diagnosis and therapy of an uncommon disease: a case report. J. Physiol. Pharmacol. 2007; 58 (Suppl. 5, Pt 1): 51–55.

37. Kırbaş G., Dağlı C.E., Tanrıkulu A.Ç. et al. Unusual combination of tracheobronchopathia osteochondroplastica and AA amyloidosis. Yonsei Med. J. 2009; 50 (5): 721–724. DOI: 10.3349/ymj.2009.50.5.721.

38. Naef A.P., Savary M., Grüneck J.S. et al. Amyloid pseudotumor treated by tracheal resection. Ann. Thorac. Surg. 1977; 23 (6): 578–581.

39. Berk J.L., O’Regan A., Skinner M. Pulmonary and tracheobronchial amyloidosis. Semin. Respir. Crit. Care Med. 2002; 23 (2): 155–165. DOI: 10.1055/s-2002-25304.

40. Road J. D., Jacques J., Sparling J. R. Diffuse alveolar septal amyloidosis presenting with recurrent hemoptysis and medial dissection of pulmonary arteries. Am. Rev. Respir. Dis. 1985; 132 (6): 1368–1370.

41. Streeten E. A, de la Monte S.M, Kennedy T.P. Amyloid infiltration of the diaphragm as a cause of respiratory failure. Chest. 1986; 89 (5): 760–762.

42. Chu H., Zhao L., Zhang Z. et al. Clinical characteristics of amyloidosis with isolated respiratory system involvement: a review of 13 cases. Ann. Thorac. Med. 2012; 7 (4): 243–249. DOI: 10.4103/1817-1737.102186.

43. Howie A.J., Owen-Casey M.P. Discrepancies between descriptions and illustrations of colours in Congo red-stained amyloid, and explanation of discrepant colours. Amyloid. 2010; 17 (3–4): 109–117. DOI: 10.3109/13506129.2010.527448.


Review

For citations:


Tret'yakov A.Yu., Zakharchenko S.P., Tret'yakova V.A. Pulmonary amyloidosis. PULMONOLOGIYA. 2018;28(1):75-83. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-1-75-83

Views: 1997


ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)