Waldenström's macroglobulinemia accompanying systemic amyloidosis: the usefulness of endobronchial ultrasound-guided transbronchial needle aspiration for detecting amyloid deposits

Intern Med. 2014;53(24):2789-93. doi: 10.2169/internalmedicine.53.2907. Epub 2014 Dec 15.

Abstract

A 75-year-old man with a history of dyspnea lasting for three years presented to our hospital. Chest computed tomography showed bilateral pulmonary nodules, some of which were calcified, in addition to mediastinal/hilar lymphadenopathy and bilateral pleural effusions. Endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) of the subcarinal lymph nodes showed amorphous acellular material compatible with λ-light chain amyloid deposits. Sternal bone marrow aspiration demonstrated increased small lymphocytes admixed with plasma cells and plasmacytoid lymphocytes. Serum immunoglobulin values were decreased with the exception of immunoglobulin M monoclonal peak. We subsequently diagnosed the patient as having Waldenström's macroglobulinemia accompanying AL-type amyloidosis. In this case, EBUS-TBNA was useful for detecting AL-type amyloidosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloidosis / diagnostic imaging*
  • Amyloidosis / etiology
  • Amyloidosis / pathology*
  • Biopsy, Needle
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Humans
  • Image-Guided Biopsy
  • Male
  • Plaque, Amyloid / diagnostic imaging*
  • Plaque, Amyloid / etiology
  • Plaque, Amyloid / pathology*
  • Waldenstrom Macroglobulinemia / complications
  • Waldenstrom Macroglobulinemia / diagnostic imaging*
  • Waldenstrom Macroglobulinemia / pathology*