A Case of Tracheobronchial Amyloidosis Treated with Endoscopic Debulking and External Beam Radiation Therapy

I. Firlinger; U. Setinek; H. Koller; P. Feurstein; H. Prosch; O. C. Burghuber; A. Valipour

doi:10.1055/s-0033-1344186

Pneumologie, Table of Contents

Pneumologie 2013; 67(07): 398-400
DOI: 10.1055/s-0033-1344186

Case Report

A Case of Tracheobronchial Amyloidosis Treated with Endoscopic Debulking and External Beam Radiation Therapy

Therapie einer tracheobronchialen Amyloidose mit endoskopischer Rekanalisation und Bestrahlung

I. Firlinger

¹Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria

,

U. Setinek

²Institute of Pathology and Bacteriology, Otto Wagner Hospital, Vienna, Austria

,

H. Koller

¹Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria

,

P. Feurstein

³Institute of Radiooncology, Wilhelminenspital, Vienna, Austria

,

H. Prosch

⁴Department of Radiology, Otto Wagner Hospital, Vienna, Austria

,

O. C. Burghuber

¹Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria

,

A. Valipour

¹Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria

› Author Affiliations

Abstract

We report on a 55-year-old patient who was admitted to hospital because of recurrent pneumonia. CT imaging provided airway narrowing and mural thickening of the distal trachea and mainstem bronchi, compatible with endobronchial polypoid, toric-shaped changes of the distal tracheal wall spreading into both the left and right bronchial system. Bronchoscopy was performed and biopsies revealed the diagnosis of tracheobronchial amyloidosis. We performed a combination of bronchoscopic debulking and consecutive external beam radiation therapy with the result of no further progression of the disease, stable endobronchial situation, and functional improvements at a follow up at 6 months.

Zusammenfassung

Wir berichten über einen 55-jährigen Patienten, der aufgrund einer rezidivierenden Pneumonie stationär aufgenommen wurde. In der Computertomographie des Thorax zeigten sich vor allem im Bereich der distalen Trachea, des rechten und linken Hauptbronchus Bronchialwandverdickungen mit polypoiden Strukturalterationen und konsekutiver Lumeneinengung der zentralen Atemwege bis in die Peripherie. Im Zuge einer Bronchoskopie wurden Zangenbiopsien der endobronchialen Veränderungen entnommen, mit dem histologischen Ergebnis einer tracheobronchialen Amyloidose. Die Behandlung erfolgte mit bronchoskopischer Rekanalisation und konventioneller Strahlentherapie mit dem zufriedenstellenden Langzeitergebnis eines rezidivfreien Intervalls und deutlicher funktioneller Verbesserung nach 6 Monaten.

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References

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