Primary pulmonary amyloidosis with multiple nodules

A 61-year old asymptomatic woman had a five-year history of pulmonary nodular lesions on routine radiographs. She underwent open lung biopsy, which revealed nodular lesions in the lungs and thickened pleura. Histological examination showed amyloid deposits in the pulmonary parenchyma and adjacent pleura. Congo Red staining of the specimen demonstrated green birefringence under polarized light. This affinity for Congo Red dye remained after potassium permanganate treatment, suggesting primary amyloidosis. Multiple nodular amyloidosis of the lungs should be included in the differential diagnosis of multiple pulmonary nodules.