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Amyloidosis Diagnosed by Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA)
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mohammed, Choudhry Muhtadi, Alnabateh Jessica, Wang Adair, Seager Christian, Woods |
| Copyright Year | 2018 |
| Abstract | Isolated mediastinal lymphadenopathy can be due to several disorders with the most common being granulomatous disorders and malignancy [1]. It is uncommon to find Amyloidosis as the cause for isolated mediastinal lymphadenopathy and to have it diagnosed via endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). Subcutaneous fat biopsy and bone marrow biopsy are the most common method for diagnosing Amyloidosis [2]. Amyloidosis is confirmed when tissue biopsies are stained with Congo red demonstrating amyloid deposits with apple green birefringence [3]. Once tissue biopsy is confirmed further testing can be done to differentiate the subtypes of Amyloidosis. We present a patient with Amyloidosis diagnosed by EBUS-TBNA. A 55-year-old African American man with past medical history of hypertension; was referred for mediastinal lymphadenopathy (Figure 1 and Figure 2) in 2017. The CT chest was performed to evaluate postoperative shortness of breath during recent hospitalization for acute appendicitis. The patient’s symptoms improved, and he was discharged home following brief hospital stay. In clinic, he only endorsed symptoms of mild fatigue and night sweats which had improved since his surgery. The patient had normal complete metabolic panel (including normal liver and renal function) and normal complete blood count panel. He had normal exercise tolerance with recent echocardiogram showing relatively normal cardiac function. He underwent an EBUS-TBNA for suspected sarcoidosis without difficulty. Lymph nodes at stations 4L, 4R, and 7 were all sampled. The original sample from lymph node station 4R underwent liquid chromatography tandem mass spectrometry (LC MS/MS) on peptides from Congo red-positive, micro-dissected areas of paraffin-embedded specimens and showed a peptide profile consistent with AL (lambda) type deposition. These samples also underwent Congo red staining (Figure 3) and showed |
| File Format | PDF HTM / HTML |
| DOI | 10.36959/918/447 |
| Volume Number | 2 |
| Alternate Webpage(s) | https://scholars.direct/Articles/pulmonology/apl-2-004.pdf |
| Alternate Webpage(s) | https://doi.org/10.36959/918%2F447 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
