A Case of Primary Localized Laryngo-tracheobronchial Amyloidosis.

Lee, Seok Jeong; Lee, Won Yeon; Jung, Soon Hee; Kwon, Woocheol; Lee, Shun Nyung; Lee, Namseok; Kim, Sang Ha; Shin, Kye Chul; Yong, Seok Joong

doi:2008.65.6.532

Tuberc Respir Dis > Volume 65(6); 2008 > Article

Case Report

Tuberculosis and Respiratory Diseases 2008;65(6):532-536.
DOI: https://doi.org/10.4046/trd.2008.65.6.532 Published online December 1, 2008.

A Case of Primary Localized Laryngo-tracheobronchial Amyloidosis.

Seok Jeong Lee, Won Yeon Lee, Soon Hee Jung, Woocheol Kwon, Shun Nyung Lee, Namseok Lee, Sang Ha Kim, Kye Chul Shin, Seok Joong Yong

¹Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. sjyong@yonsei.ac.kr
²Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
³Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

We report on a case of a patient with laryngo-tracheobronchial amyloidosis who complained of cough, sputum, and hoarseness. A chest X-ray showed consolidation in the right middle lobe. A chest CT scan showed diffuse, irregular narrowing of the tracheobronchial tree and atelectasis of the right middle lobe, with calcification of bronchial wall. Bronchoscopic findings were multinodular submucosal thickening of the right vocal cord, and yellowish multinodular submucosal thickening from the lower trachea through both main bronchi, as well as the lingular division of the left upper lobe, the right middle lobe, and the right lower lobe. The right middle lobe bronchus was nearly obstructed. The diagnosis of amyloidosis was made by multiple bronchoscopic biopsies on the right vocal cord and both bronchi. Pathologic findings were characteristic apple-green birefringence under polarized microscopy with Congo-red stain. The patient had no evidence of systemic amyloidosis. The patient is under conservative symptomatic treatment.

Key Words: Tracheobronchial amyloidosis, Laryngeal amyloidosis, Right middle lobe syndrome, Hoarseness