Archive for the 'Amyloidosis and Pleural Disease' Category

09 Nov

Amyloidosis and Pleural Disease: Discussion (Part 3)

During examination of patients with pleural effusions, if history suggests the presence of multiorgan disease and there is suspicion for systemic amyloidosis, then a closed pleural biopsy with special stains for amyloid should be performed. Routinely prepared microscopic sections stained with hematoxylin-eosin may not suggest amyloidosis. Special stains, such as crystal violet or Congo red […]

08 Nov

Amyloidosis and Pleural Disease: Discussion (Part 2)

All patients had unequivocal evidence for systemic amyloidosis by demonstrating amyloid deposition in at least one other organ system. Seven of nine patients in whom the cause of amyloidosis has been established, including four of five patients from our series, had primary amyloidosis related to plasma cell dyscrasia. This has been well described in the […]

07 Nov

Amyloidosis and Pleural Disease: Discussion (Part 1)

Pleural effusions appear to occur not infrequently in patients with systemic amyloidosis, 30 percent in one series. The cause for the pleural efiusions is most often congestive heart failure. Indeed, a large review of 333 patients with systemic amyloidosis from 13 studies revealed that the incidence of histologic involvement of the heart was 66 percent, […]

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 […]

05 Nov

Amyloidosis and Pleural Disease: Case Reports (Part 1)

Case 1 A 71-year-old woman presented in April 1987 for evaluation of a two-year history of progressive dyspnea on exertion and right pleural effusion. She had a two-year history of seronegative rheumatoid arthritis and Sjogren’s syndrome. In August 1986 she underwent a small bowel biopsy for evaluation of chronic diarrhea and was diagnosed as having […]

04 Nov

Amyloidosis and Pleural Disease

The reported prevalence of pulmonary involvement in patients with systemic amyloidosis ranges from 30 percent to 92 percent. Autopsy series have traditionally classified patterns of pulmonary involvement as being alveolar, tracheobronchial, and/or vascular in nature. Most series have not described histologic evidence for pleural disease with amyloidosis. Indeed, there have been only rare case reports […]

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