EBUS-GSを用いた経気管支生検が診断に有用であった限局性肺アミロイドーシスの1例
背景．アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが，ガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a guide-sheath：EBUS-GS）を用いた生検での診断例は稀である．症例．80歳男性．胸部異常影で当科を紹介され，胸部CTで左S1＋2aに長径20 mm大の石灰化を伴う結節を指摘された．その後9年間の経過観察中に緩徐に増大したため精査となった．EBUS-GSを用いた経気管支生検（transbronchial biopsy：TBB）の結果，アミロイドーシスと診断した．他臓器にア...
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| Published in | The Journal of the Japan Society for Respiratory Endoscopy Vol. 40; no. 5; pp. 473 - 478 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器内視鏡学会
25.09.2018
日本呼吸器内視鏡学会 The Japan Society for Respiratory Endoscopy |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0287-2137 2186-0149 |
| DOI | 10.18907/jjsre.40.5_473 |
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| Abstract | 背景．アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが，ガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a guide-sheath：EBUS-GS）を用いた生検での診断例は稀である．症例．80歳男性．胸部異常影で当科を紹介され，胸部CTで左S1＋2aに長径20 mm大の石灰化を伴う結節を指摘された．その後9年間の経過観察中に緩徐に増大したため精査となった．EBUS-GSを用いた経気管支生検（transbronchial biopsy：TBB）の結果，アミロイドーシスと診断した．他臓器にアミロイド沈着を認めず，基礎疾患もないため限局性肺アミロイドーシスと判断した．結論．EBUS-GSを用いた生検は限局性肺アミロイドーシスの診断に有用であった． |
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| AbstractList | Background. Localized pulmonary amyloidosis is the form of amyloidosis characterized by the deposition in the respiratory tract. However, there are few reports of pulmonary amyloidosis diagnosed by biopsy using endobronchial ultrasonography with a guide-sheath (EBUS-GS). Case. An asymptomatic 80-year-old man was referred to our hospital because of an abnormal shadow detected on chest radiography. Chest CT scans revealed a 20 mm pulmonary nodule with calcification in the left S1+2a segment of the lung. Since the nodule had enlarged slowly during 9 years, bronchoscopy was performed for diagnosis. The tissue specimens were obtained by transbronchial biopsy (TBB) using EBUS-GS from the left B1+2aiiα. Pathological examination indicated deposits of eosinophilic amorphous material positively stained with Congo-red. These findings were consistent with a diagnosis of amyloidosis. Since neither deposits of amyloid in other organs nor underlying inflammatory disorder were demonstrated, we diagnosed this case as localized pulmonary amyloidosis. Conclusion. Bronchoscopy using the EBUS-GS method was useful for the diagnosis of localized pulmonary amyloidosis.
背景．アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが，ガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a guide-sheath：EBUS-GS）を用いた生検での診断例は稀である．症例．80歳男性．胸部異常影で当科を紹介され，胸部CTで左S1＋2aに長径20 mm大の石灰化を伴う結節を指摘された．その後9年間の経過観察中に緩徐に増大したため精査となった．EBUS-GSを用いた経気管支生検（transbronchial biopsy：TBB）の結果，アミロイドーシスと診断した．他臓器にアミロイド沈着を認めず，基礎疾患もないため限局性肺アミロイドーシスと判断した．結論．EBUS-GSを用いた生検は限局性肺アミロイドーシスの診断に有用であった． 「要約」 - 「背景.」アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが, ガイドシース併用気管支腔内超音波断層法 (endobronchial ultrasonography with a guide-sheath : EBUS-GS) を用いた生検での診断例は稀である. 「症例.」80歳男性. 胸部異常影で当科を紹介され, 胸部CTで左S1+2aに長径20mm大の石灰化を伴う結節を指摘された. その後9年間の経過観察中に緩徐に増大したため精査となった. EBUS-GSを用いた経気管支生検 (transbronchial biopsy : TBB) の結果, アミロイドーシスと診断した. 他臓器にアミロイド沈着を認めず, 基礎疾患もないため限局性肺アミロイドーシスと判断した. 「結論.」EBUS-GSを用いた生検は限局性肺アミロイドーシスの診断に有用であった. 背景．アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが，ガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a guide-sheath：EBUS-GS）を用いた生検での診断例は稀である．症例．80歳男性．胸部異常影で当科を紹介され，胸部CTで左S1＋2aに長径20 mm大の石灰化を伴う結節を指摘された．その後9年間の経過観察中に緩徐に増大したため精査となった．EBUS-GSを用いた経気管支生検（transbronchial biopsy：TBB）の結果，アミロイドーシスと診断した．他臓器にアミロイド沈着を認めず，基礎疾患もないため限局性肺アミロイドーシスと判断した．結論．EBUS-GSを用いた生検は限局性肺アミロイドーシスの診断に有用であった． |
| Author | 大坪, 亜矢 眞水, 飛翔 佐藤, 佑輔 石田, 卓士 小林, 理 古川, 俊貴 太田, 毅 澤田, 龍兵 田中, 知宏 |
| Author_FL | Furukawa Toshiki Ishida Takashi Ohtsubo Aya Sato Yusuke Mamizu Hikaru Tanaka Tomohiro Sawada Ryuhei Ohta Takeshi Kobayashi Osamu |
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| References | 4. 樋口光徳, 郡司崇志, 鈴木弘行, ほか. 原発性結節性肺アミロイドーシスの1例. 日呼外会誌. 1997;11:34-39. 7. Chew KM, Clarke MJ, Dubey N, et al. Nodular pulmonary amyloidosis with unusual, widespread lung cysts. Singapore Med J. 2013;54:e97-e99. 9. Kanamori K, Kurahori J, Takenaka M, et al. A case of localized pulmonary amyloidosis diagnosed by transbronchial biopsy with a long-term observation. J Jpn Soc Respir Endoscopy. 2013;35:530-536. 1. Wright JR, Calkins E, Humphrey RL. Potassium permanganate reaction in amyloidosis. A histologic method to assist in differentiating forms of this disease. Lab Invest. 1977;36:274-281. 10. Ohdachi T, Okumura N, Fukatsu A, et al. A case of localized nodular pulmonary amyloidosis diagnosed by a transbronchial biopsy using endobronchial ultrasonography with a guide sheath. J Jpn Soc Respir Endoscopy. 2017;39:508-512. 8. Okamoto S, Togo S, Nagata I, et al. Lung adenocarcinoma expressing receptor for advanced glycation end-products with primary systemic AL amyloidosis: a case report and literature review. BMC Cancer. 2017;17:22. 3. Addis BJ. Pulmonary lymphoproliferative disease. In: Hasleton PS, Flieder DB, eds. Spencer's Pathology of the Lung. 6th ed, Cambridge: Cambridge University Press; 2013:1316-1374. 5. Kuroki S, Nagata M, Iwanaga K, et al. A case of primary nodular pulmonary amyloidosis diagnosed by transbronchial lung biopsy. J Jpn Soc Bronchol. 2000;22:296-299. 6. Govender P, Keyes CM, Hankinson EA, et al. Transbronchial biopsies safely diagnose amyloid lung disease. Amyloid. 2017;24:37-41. 2. Khoor A, Colby TV. Amyloidosis of the lung. Arch Pathol Lab Med. 2017;141:247-254. |
| References_xml | – reference: 1. Wright JR, Calkins E, Humphrey RL. Potassium permanganate reaction in amyloidosis. A histologic method to assist in differentiating forms of this disease. Lab Invest. 1977;36:274-281. – reference: 4. 樋口光徳, 郡司崇志, 鈴木弘行, ほか. 原発性結節性肺アミロイドーシスの1例. 日呼外会誌. 1997;11:34-39. – reference: 5. Kuroki S, Nagata M, Iwanaga K, et al. A case of primary nodular pulmonary amyloidosis diagnosed by transbronchial lung biopsy. J Jpn Soc Bronchol. 2000;22:296-299. – reference: 2. Khoor A, Colby TV. Amyloidosis of the lung. Arch Pathol Lab Med. 2017;141:247-254. – reference: 8. Okamoto S, Togo S, Nagata I, et al. Lung adenocarcinoma expressing receptor for advanced glycation end-products with primary systemic AL amyloidosis: a case report and literature review. BMC Cancer. 2017;17:22. – reference: 6. Govender P, Keyes CM, Hankinson EA, et al. Transbronchial biopsies safely diagnose amyloid lung disease. Amyloid. 2017;24:37-41. – reference: 7. Chew KM, Clarke MJ, Dubey N, et al. Nodular pulmonary amyloidosis with unusual, widespread lung cysts. Singapore Med J. 2013;54:e97-e99. – reference: 10. Ohdachi T, Okumura N, Fukatsu A, et al. A case of localized nodular pulmonary amyloidosis diagnosed by a transbronchial biopsy using endobronchial ultrasonography with a guide sheath. J Jpn Soc Respir Endoscopy. 2017;39:508-512. – reference: 9. Kanamori K, Kurahori J, Takenaka M, et al. A case of localized pulmonary amyloidosis diagnosed by transbronchial biopsy with a long-term observation. J Jpn Soc Respir Endoscopy. 2013;35:530-536. – reference: 3. Addis BJ. Pulmonary lymphoproliferative disease. In: Hasleton PS, Flieder DB, eds. Spencer's Pathology of the Lung. 6th ed, Cambridge: Cambridge University Press; 2013:1316-1374. |
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| Snippet | 背景．アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが，ガイドシース併用気管支腔内超音波断層法（endobronchial ultrasonography with a... 「要約」 - 「背景.」アミロイドーシスのうち呼吸器系のみにアミロイド沈着するものを限局性肺アミロイドーシスと呼ぶが, ガイドシース併用気管支腔内超音波断層法 (endobronchial ultrasonography with a guide-sheath : EBUS-GS) を用いた生検での診断例は稀である.... Background. Localized pulmonary amyloidosis is the form of amyloidosis characterized by the deposition in the respiratory tract. However, there are few reports... |
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| SubjectTerms | Bronchoscopy EBUS-GS Localized pulmonary amyloidosis Transbronchial biopsy 気管支鏡検査 経気管支生検 限局性肺アミロイドーシス |
| Title | EBUS-GSを用いた経気管支生検が診断に有用であった限局性肺アミロイドーシスの1例 |
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