Enlarging mediastinal/hilar lymphadenopathy with calcification

Abstract

A 77-year-old man was referred to our hospital due to enlarging mediastinal/hilar lymphadenopathy with calcification. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and bone marrow aspiration were performed. Subsequently, monoclonal gammopathy of undetermined significance (MGUS) associated with mediastinal amyloidosis was diagnosed. We hereby report a case in which EBUS-TBNA led to a successful diagnosis of amyloidosis.

Keywords: endobronchial ultrasound‐guided transbronchial needle aspiration; mediastinal/hilar amyloidosis.

Figure 1

Chest CT on parenchymal (A) and mediastinal (B) window settings showed right pleural effusion and mediastinal/hilar lymphadenopathy with calcification.

Figure 2

Cytology of the lymph node. A lump of amorphous light green material (Papaniclaou staining, ×200).

Figure 3

Histology of the lymph node. (A) Section showing amorphous eosinophilic materials with hematoxylin–eosin staining (H&E, ×200). (B) These materials stained positive for direct first scarlet staining (DFS, ×200), indicating amyloid deposits.