Atypical Nodular Pulmonary Kappa Light-Chain Deposition
Jessy Nellipudi1,2, John Brealey3, Sonja Klebe2,3
1Department of Cardiothoracic Surgery, Flinders Medical Centre, Southern Adelaide Local Health Network, South Australia, Australia.
Case Reports in Pathology
|March 29, 2021
Summary
This case study describes a lung lesion identified via positron emission tomography (PET) scan. The lesion was confirmed as kappa light-chain deposition, a rare condition, after surgical removal and detailed analysis.
Area of Science:
- Pulmonary Medicine
- Pathology
- Nephrology
Background:
- Incidental lung lesions detected by positron emission tomography (PET) scans require thorough investigation.
- Malignancy is a primary concern for growing lung lesions, necessitating surgical intervention.
Observation:
- A right middle lobe lesion, increasing in size and PET-avid, was surgically resected.
- Microscopic examination revealed a poorly circumscribed lesion with eosinophilic material.
- The material showed strong kappa light chain labeling but weak, non-specific Congo red staining.
Findings:
- Electron microscopy confirmed fibrillar amyloid-like material.
- The pathological features were consistent with kappa light-chain deposition disease.
- This diagnosis was made despite atypical Congo red birefringence, highlighting the importance of combined techniques.
Implications:
- This case expands the understanding of extraskeletal kappa light-chain deposition.
- It underscores the importance of considering light-chain deposition in pulmonary lesions, even with atypical staining.
- Accurate diagnosis is crucial for appropriate patient management and prognosis.
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