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Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation

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Published on: October 11, 2024

Nodular amiodarone lung disease.

Ruchira Ruangchira-Urai¹, Thomas V Colby, Julianne Klein

¹Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.

The American Journal of Surgical Pathology

|August 30, 2008

Summary

Nodular amiodarone lung disease (ALD) presents as lung nodules, often mistaken for cancer. Histopathology reveals vacuolated histiocytes causing tissue destruction, aiding diagnosis even without drug history.

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Area of Science:

Pulmonology
Pathology
Pharmacology

Background:

Amiodarone, an antiarrhythmic medication, is known to accumulate in various organs.
Amiodarone lung disease (ALD) typically presents as interstitial pneumonitis.
Nodular ALD is rare and poorly described histopathologically.

Observation:

This study details the histopathology of four patients with nodular ALD.
Patients presented with lung nodules initially suspected as malignancy.
Histopathology revealed vacuolated histiocytes forming nodules with tissue breakdown.

Findings:

All four cases showed similar histopathology: massed vacuolated histiocytes within alveoli.
Ultrastructural examination confirmed amiodarone inclusions in histiocytes.
Tissue destruction by histiocytes indicated disease, not just drug effect.

Implications:

The necrotizing nature of histiocytes suggests amiodarone toxicity as the cause of nodular ALD.
This finding aids in diagnosing nodular ALD, even when amiodarone use is not initially known.
Highlights the importance of considering drug toxicity in unexplained lung nodules.