06 Nov

Amyloidosis and Pleural Disease: Case Reports (Part 2)

Case 3
A 61-year-old woman was referred for evaluation of a six-month history of dyspnea on exertion, pedal edema, and a large rightsided pleural effusion. Right thoracentesis and Cope needle biopsy of the pleura were performed. Congo red and crystal violet stains demonstrated amyloid deposition in the pleura. A two-dimensional echocardiogram was suggestive of marked hypertrophy and noncompliance of both ventricles. A bone marrow biopsy specimen revealed a moderate plasmacytosis with 6 percent mature plasma cells, 4 percent immature plasma cells, and 1 percent plasmablasts. buy levaquin online
Case 4
A 57-year-old woman was referred for evaluation of mild dyspnea, weight loss, and a recurrent right pleural effusion in February 1987. The patient was diagnosed as having amyloidosis based on a biopsy specimen from a skin lesion on the nape of the neck in September 1986. Evaluation at that time suggested a plasma cell dyscrasia with an M spike in both serum and urine electrophoresis, and a 10 percent plasmacytosis on the bone marrow biopsy specimen. The patient has had congestive heart failure with bilateral pleural effusions. The right-sided pleural effusion has persisted despite aggressive diuretic therapy. Cope needle biopsy of the pleura demonstrated amyloid deposition by Congo red stain. In April 1987, the patient underwent an open lung biopsy for evaluation of interstitial infiltrates. Extensive amyloid deposition was demonstrated throughout the lung parenchyma. Bone marrow aspiration and biopsy specimen demonstrated no abnormality at this time.
Case 5
An 81-year-old woman presented with a two-year history of ankle edema that had progressed to generalized edema, ascites, and bilateral pleural effusions over the past one year. A Cope needle biopsy of the pleura demonstrated amyloid deposition by Congo red stain. The crystal violet stain failed to reveal any abnormality. A bone marrow biopsy specimen showed a plasmacytosis of 21 percent.

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