乳腺病変を合併した肺アミロイドーシスの1例

A case of pulmonary amyloidosis with breast lesion

アミロイドーシスは，異常蛋白であるアミロイドが全身に沈着し多彩な病変を示す疾患である。肺野領域では，石灰化や嚢胞形成を伴う結節，腫瘤を認めた際にアミロイドーシスを鑑別疾患の一つに挙げ，他臓器病変の有無や続発性の可能性を考慮する必要がある。我々は原発性肺癌と鑑別を要する肺病変と，乳腺病変を併発したアミロイドーシスの1例を経験した。肺アミロイドーシスについて画像所見と文献的考察を交えて報告する。

The patient is in her 70 s. Her CT scan showed central lobular and nodular shadows in the right lower lobe of her lung, some of which were accompanied by cystic lesions and calcification, and nodules with calcification in the right breast. Amyloidosis was suspected as the primary cause, but lung cancer could not be ruled out. Then a thoracoscopic partial resection of the right lung was performed. Pathology showed diffuse deposition of eosinophilic unstructured material in the lung nodule, which was Congo-red positive. The diagnosis was pulmonary parenchymal amyloidosis. A needle biopsy of the right breast also showed amyloidosis. When we find some nodules with cystic lesions and calcification of the lung, amyloidosis can be determined as a differential diagnosis, and we need to search for other organ lesions and disease. Herein we report pulmonary amyloidosis with image findings and some literature review.