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Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules
Published on: May 23, 2015
An uncommon cause of bilateral pulmonary nodules in a long-term smoker
1Department of Medicine, University of Tennessee, College of Medicine-Chattanooga Unit, 975 East Third St., P.O. Box 94, Chattanooga, Tennessee 37403, USA. doctorkumargaurav@yahoo.com
Background:
Dyspnea caused by pulmonary disease is a common symptom encountered by internists. The most likely diagnosis of pulmonary nodules in a long-term smoker is lung cancer. PATIENT/PARTICIPANT: We report a case of an elderly male with a 70-pack-year smoking history, presenting with exertional dyspnea for 6 months.
Interventions:
Detailed review of history was negative. Examination was normal except for diminished breath sounds in all lung fields. Chest x-ray showed bilateral nodular opacities. Computed tomography of thorax revealed multiple bilateral lung masses. A whole-body positron emission tomography revealed enhancement only of the pulmonary masses. Bronchoalveolar lavage was negative for acid fast bacilli, nocardia, and fungi.
Main Results:
Lung biopsy showed findings consistent with amyloidosis. Bone marrow biopsy done to investigate primary amyloidosis showed no clonal plasma cells or amyloid staining, thus suggesting a diagnosis of localized pulmonary amyloidosis. Patient is being managed conservatively with close follow-up for signs of progression.
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