Histopathological study of corpora amylacea pulmonum

In this paper, we present a rare disorder which is known as corpora amylacea pulmonum. X-ray CT scanning showed an abnormal focus of the lung as a solitary mass with high density and spicular features around the surface. The resected lung tissue was characterized by the appearance of round, concentrically laminated acellular bodies about 40-80 microns in diameter. The bodies were usually found lying free in the alveolar space and surrounded by the exudate alveolar macrophages or multinuclear giant cells. Some of these macrophages were in a state of progressive degeneration. The bodies showed an affinity for Congo red and exhibited partial birefringence. Moreover, all the bodies had a strong positivity for the PAS reaction and anti lysozyme antibodies. The exudate alveolar macrophages and multinuclear giant cells also displayed reactivity for PAS and lysozyme in a similar manner to that of the bodies. Electron microscopically the bodies were fundamentally composed of fibrillar elements, which bore some resemblance to amyloid fibrils and probably accounted for the partial affinity of the bodies for Congo red. These amyloid-like fibrils were also found in the cytoplasm of the macrophages. This suggested that the concentrically laminated bodies in corpora amylacea pulmonum might be formed by sequential aggregation, fusion, coalescence and compaction of degenerated alveolar macrophages.