Chest
Volume 114, Issue 5, November 1998, Pages 1489-1492
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Selected Reports
Radiation Therapy for Tracheobronchial Amyloidosis

https://doi.org/10.1378/chest.114.5.1489Get rights and content

A 67-year-old man presented with localized tracheobronchial amyloidosis involving the distal trachea and the right-sided airways. The disease caused right middle lobe collapse and threatened the right upper and lower lobes. A variety of bronchoscopic methods, including Nd:YAG laser resection, dilation, and stenting, were used as temporizing methods. External beam radiation therapy, considered because of disease progression, caused a measurable local response. Radiation therapy should be considered as a treatment option for localized tracheobronchial amyloidosis causing airway obstruction.

Section snippets

Case Report

In November 1994, a 67-year-old white male retired general contractor was admitted to the hospital for removal of an acoustic neuroma. His medical history was not significant and he was taking no medications. Findings from physical examination were unremarkable and results of laboratory tests, including serum chemistries, CBC count, and urinalysis, were normal. A preoperative chest radiograph showed partial collapse of the right middle lobe (RML). Bronchoscopy revealed abnormal mucosa in the

Discussion

Amyloidosis of the lower respiratory tract is a relatively rare disorder. Several literature reviews and small series6, 7, 8, 9, 10 have found that the tracheobronchial form of pulmonary amyloidosis accounts for 25 to 50% of the cases of amyloidosis limited to the lung. This patient had no clinical evidence of systemic amyloidosis, serum protein electrophoresis was normal, and tracheobronchial amyloidosis is generally thought not to be associated with systemic amyloidosis.6, 7, 8, 9 Therefore,

ACKNOWLEDGMENTS

We thank members of the Laser Surgery Institute (University of Utah Medical Center) and the Department of Anesthesiology for assistance in management of this challenging patient.

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This work was supported by the Department of Veterans Affairs (VA), the Nora Eccles Treadwell Foundation, and the Richard A. and Nora Eccles Harrison Fund for Cardiovascular Research.

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