CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis
Pulmonary involvement in Sjogren syndrome (SS) could manifest as cystic lung disease (CLD). CLD in SS includes lymphocytic interstitial pneumonia (LIP) and pulmonary amyloidosis. Differential diagnosis usually requires surgical lung biopsy, whereas CT-guided percutaneous fine needle aspiration biops...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-11-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043320304039 |
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| author | Claudio Tirelli, MD Giovanni Zanframundo, MD Adele Valentini, MD Chandra Bortolotto, MD Roberto Dore, MD Tiberio Oggionni, MD Paolo Milani, MD, PhD Elena Bravi, MD Zamir Kadija, MD Francesca Mariani, MD, PhD Veronica Codullo, MD, PhD Patrizia Morbini, MD, PhD Giovanni Palladini, MD, PhD Federica Meloni, MD, PhD Lorenzo Cavagna, MD |
| author_facet | Claudio Tirelli, MD Giovanni Zanframundo, MD Adele Valentini, MD Chandra Bortolotto, MD Roberto Dore, MD Tiberio Oggionni, MD Paolo Milani, MD, PhD Elena Bravi, MD Zamir Kadija, MD Francesca Mariani, MD, PhD Veronica Codullo, MD, PhD Patrizia Morbini, MD, PhD Giovanni Palladini, MD, PhD Federica Meloni, MD, PhD Lorenzo Cavagna, MD |
| author_sort | Claudio Tirelli, MD |
| collection | DOAJ |
| description | Pulmonary involvement in Sjogren syndrome (SS) could manifest as cystic lung disease (CLD). CLD in SS includes lymphocytic interstitial pneumonia (LIP) and pulmonary amyloidosis. Differential diagnosis usually requires surgical lung biopsy, whereas CT-guided percutaneous fine needle aspiration biopsy (CT-FNAB) has not yet explored. We describe the case of a 63-year-old never smoker Caucasian female with a SS diagnosis who displayed a newly detected diffuse CLD at high-resolution computed tomography, though totally asymptomatic. Given the favorable location of one big lesion at the superior left lobe, a CT-FNAB was proposed instead of a more invasive SLB. At histology examination a diagnosis of pulmonary nodular AL kappa amyloidosis in the context of SS was established. In conclusion, CT-FNAB might represent an alternative and less invasive diagnostic procedure than SLB in the differential diagnosis of CLD, even if further research is needed. Moreover, this case presents an unusual association between SS and pulmonary nodular AL kappa amyloidosis, with pulmonary nodules and cysts without systemic manifestations. |
| first_indexed | 2024-12-12T08:50:22Z |
| format | Article |
| id | doaj.art-6f0c8520bc944c2c8cb28d791cc197bc |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-12T08:50:22Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-6f0c8520bc944c2c8cb28d791cc197bc2022-12-22T00:30:16ZengElsevierRadiology Case Reports1930-04332020-11-01151123312334CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosisClaudio Tirelli, MD0Giovanni Zanframundo, MD1Adele Valentini, MD2Chandra Bortolotto, MD3Roberto Dore, MD4Tiberio Oggionni, MD5Paolo Milani, MD, PhD6Elena Bravi, MD7Zamir Kadija, MD8Francesca Mariani, MD, PhD9Veronica Codullo, MD, PhD10Patrizia Morbini, MD, PhD11Giovanni Palladini, MD, PhD12Federica Meloni, MD, PhD13Lorenzo Cavagna, MD14Department of Internal Medicine and Therapeutics, Division of Respiratory Diseases, University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Corresponding author.Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyDivision of Radiology, IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyDivision of Radiology, IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyRadiology Unit, Istituti Clinici Città di Pavia, Pavia, ItalyDivision of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation ''Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo'', University of Pavia, Pavia, ItalyUnit of Rheumatology, Guglielmo da Saliceto Hospital, Piacenza, ItalyDivision of Internal Medicine, Azienda Sanitaria dell'Alto Adige, Brunico Hospital, Brunico, ItalyDivision of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDivision of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyPathology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyDepartment of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation ''Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo'', University of Pavia, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, Division of Respiratory Diseases, University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDivision of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, ItalyPulmonary involvement in Sjogren syndrome (SS) could manifest as cystic lung disease (CLD). CLD in SS includes lymphocytic interstitial pneumonia (LIP) and pulmonary amyloidosis. Differential diagnosis usually requires surgical lung biopsy, whereas CT-guided percutaneous fine needle aspiration biopsy (CT-FNAB) has not yet explored. We describe the case of a 63-year-old never smoker Caucasian female with a SS diagnosis who displayed a newly detected diffuse CLD at high-resolution computed tomography, though totally asymptomatic. Given the favorable location of one big lesion at the superior left lobe, a CT-FNAB was proposed instead of a more invasive SLB. At histology examination a diagnosis of pulmonary nodular AL kappa amyloidosis in the context of SS was established. In conclusion, CT-FNAB might represent an alternative and less invasive diagnostic procedure than SLB in the differential diagnosis of CLD, even if further research is needed. Moreover, this case presents an unusual association between SS and pulmonary nodular AL kappa amyloidosis, with pulmonary nodules and cysts without systemic manifestations.http://www.sciencedirect.com/science/article/pii/S1930043320304039Sjogren syndromeCystic lung diseaseAmyloidosisCT guided fine needle aspiration biopsy |
| spellingShingle | Claudio Tirelli, MD Giovanni Zanframundo, MD Adele Valentini, MD Chandra Bortolotto, MD Roberto Dore, MD Tiberio Oggionni, MD Paolo Milani, MD, PhD Elena Bravi, MD Zamir Kadija, MD Francesca Mariani, MD, PhD Veronica Codullo, MD, PhD Patrizia Morbini, MD, PhD Giovanni Palladini, MD, PhD Federica Meloni, MD, PhD Lorenzo Cavagna, MD CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis Radiology Case Reports Sjogren syndrome Cystic lung disease Amyloidosis CT guided fine needle aspiration biopsy |
| title | CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis |
| title_full | CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis |
| title_fullStr | CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis |
| title_full_unstemmed | CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis |
| title_short | CT-guided biopsy in the differential diagnosis of Sjogren syndrome associated cystic lung disease: A case of lung nodular AL-k amyloidosis |
| title_sort | ct guided biopsy in the differential diagnosis of sjogren syndrome associated cystic lung disease a case of lung nodular al k amyloidosis |
| topic | Sjogren syndrome Cystic lung disease Amyloidosis CT guided fine needle aspiration biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S1930043320304039 |
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