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Case Reports
. 2007 Nov;22(11):1617-20.
doi: 10.1007/s11606-007-0324-z. Epub 2007 Sep 12.

An uncommon cause of bilateral pulmonary nodules in a long-term smoker

Kumar Gaurav  1 , Mukta Panda
Affiliations
Case Reports

An uncommon cause of bilateral pulmonary nodules in a long-term smoker

Kumar Gaurav et al. J Gen Intern Med. 2007 Nov.

Abstract

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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Figures

Figure 1
Figure 1
Chest x-ray showing bilateral ill-defined nodular opacities (arrows)
Figure 2
Figure 2
Spiral computed tomography of thorax showing soft tissue lung mass (arrow)
See this image and copyright information in PMC

References

    1. Ingram RH Jr., Braunwald E. Dyspnea and pulmonary edema. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, eds. Harrison’s Principles of Internal Medicine—16th Ed. New York: McGraw-Hill; 2006:203.
    1. Wingo PA, Ries LA, Giovino GA, et al. Annual report to the nation on the status of cancer, 1973–1996, with a special section on lung cancer and tobacco smoking. J Natl Cancer Inst. 1999;91(8):675–90. - DOI - PubMed
    1. The American Thoracic Society. Dyspnea. Mechanisms, assessment, and management: a consensus statement. Am J Respir Crit Care Med. 1999;159:321–40. - PubMed
    1. Pratter MR, Curley FJ, Dubois J, Irwin RS. Cause and evaluation of chronic dyspnea in a pulmonary disease clinic. Arch Intern Med. 1989;149(10):2277–82. - DOI - PubMed
    1. Chesnutt MS, Prendergast TJ. Common manifestations of lung disease. In: Tierney LM Jr., McPhee SJ, Papadakis MA, et al, eds. Current Medical Diagnosis & Treatment—45th Ed. New York: McGraw-Hill; 2006:215.

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