1.A case of wild-type transthyretin amyloidosis associated with organizing pneumonia
Makoto Nakao ; Hideki Muramatsu ; Eriko Yamamoto ; Yuto Suzuki ; Sousuke Arakawa ; Ken Tomooka ; Yusuke Sakai ; Kouhei Fujita ; Hidefumi Sato
Journal of Rural Medicine 2017;12(2):130-134
An 81-year-old man was referred to our hospital with bilateral multiple patchy opacities on chest radiography. His chief complaints were a few months’ history of intermittent mild cough and slightly yellow sputum. Chest computed tomography (CT) showed non-segmental air-space consolidations with ground-glass opacities. Amyloid deposition with organizing pneumonia (OP) was seen in transbronchial lung biopsy (TBLB) specimens from the left S8. Three months later, the infiltration originally seen in the left lower lobe was remarkably diminished, and new infiltrations in the lingual and right lower lobes were detected on chest CT. Amyloid deposition with OP was seen in TBLB specimens from the left S4. Transthyretin was detected following immunohistochemical examination. The presence of wild-type transthyretin (ATTRwt) was proven using genetic analysis. The present report describes a rare case of ATTRwt amyloidosis associated with OP.
2.A Case of Primary Racemose Hemangioma Discovered from Abnormal Chest X-ray Finding
Ken TOMOOKA ; Makoto NAKAO ; Seiji KAMEI ; Yuto SUZUKI ; Yusuke SAKAI ; Sousuke ARAKAWA ; Yusuke KAGAWA ; Ryota KUROKAWA ; Hidefumi SATO ; Yoshimi HORIKAWA ; Hideki MURAMATSU
Journal of the Japanese Association of Rural Medicine 2017;66(1):79-85
A 56-year-old woman was referred to our hospital because of an abnormal finding in the right pulmonary hilum on chest X-ray. Enhanced chest computed tomography showed hyperplastic bronchial arteries dilating and winding around the trachea and bronchi. A racemose hemangioma of the bronchial artery with multiple bronchial artery aneurysms (diameter <20mm) was seen displacing the trachea and both main bronchi. Bronchoscopy showed submucosal tumor-like lesions at the distal trachea and in both main bronchi, and a dusky-red elevated pulsatile lesion at the orifice of the left B3b+c. We performed coil embolization of the bronchial artery aneurysm to prevent abrupt rupture of the bronchial aneurysm.