A Case of Tracheal and Bronchial Amyloidosis with a Rapid Course

DOI
  • Yamaguchi Miho
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Tsukada Azusa
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Yamamoto Miake
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Kobayashi Takeshi
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Murata Kengo
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Wada Akihiko
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
  • Takamori Mikio
    Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center

Bibliographic Information

Other Title
  • 急激な経過を辿り，死後に気管・気管支アミロイドーシスが判明した1例

Search this article

Abstract

<p>Background. Tracheal and bronchial amyloidosis is a rare disease with non-specific symptoms, making the diagnosis difficult. Case. A male patient in his 80s presented to our hospital with complaints of a decreased appetite and difficulty walking for the past 2 days. Chest computed tomography (CT) showed emphysematous changes and an invasive shadow in the left upper lobe. He was admitted and began antimicrobial drug therapy for bacterial pneumonia. The inflammation showed signs of improving, but the fever and respiratory symptoms did not. He initially had an independent functional status according to his activities of daily living, but he experienced disorientation and difficulty with accessory movements. He had no difficulty swallowing during the water drinking test at admission but continued to experience difficulty eating. Head CT and magnetic resonance imaging (MRI) showed no significant pathological findings. Bronchoscopy performed after the sudden appearance of left atelectasis revealed right vocal cord paralysis and a large amount of purulent sputum in the trachea and bronchi. Furthermore, multiple, flat lesions in the middle and lower trachea and the left and right bronchi were observed. A biopsy of the lesions in the trachea and left second tracheal bifurcation was performed. His general condition did not improve, and he died on day 18 of illness. The postmortem results of the tracheal and bronchial biopsies revealed AL (κ) amyloidosis. Conclusion. We experienced a case of tracheal and bronchial amyloidosis with a relatively rapid course. Hoarseness as a symptom of complications of tracheal and bronchial amyloidosis has previously been reported, and aspiration due to vocal cord paralysis might have caused the refractory pneumonia and atelectasis in the present case.</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top