Pulmonary Amyloidoma: A Rare Entity Complicating a Post-Heart Transplant Course
نویسندگان
چکیده
IntroductionHeart transplantation (HT) is a viable, life-prolonging therapy for patients with severe cardiac amyloidosis. Unique amyloid-related pathology may complicate their care. We present case of rare manifestation amyloidosis complicating post-HT course.Case ReportA 51-year-old female AL (treated daratumumab, cyclophosphamide, bortezomib, and dexamethasone) chronic kidney disease was transferred advanced options evaluation. She presented in cardiogenic shock PEA arrest requiring escalation to venoarterial-ECMO. Admission sputum culture positive Enterobacter cloacae. CT scan revealed right lower lobe consolidation 5cm cavitary lesion concerning aspiration pneumonia. Broad spectrum antibiotics were initiated. Given near-complete resolution her light chains on chemotherapy, Oncology agreed proceed transplantation. emergently listed as status 1 underwent heart-kidney One-week post-HT, she developed leukocytosis abdominal discomfort but remained afebrile only mild dyspnea. Abdominal incidentally noted an 11cm lung lesion. Dedicated chest raised concern aspergilloma or other necrotizing pneumonia (Figure 1). Bronchoalveolar lavage had unremarkable fungal viral studies did reveal Acinetobacter. Antibiotics appropriately adjusted. VATS attempted required conversion thoracotomy lobectomy. Pathology necroinflammatory findings Congo-red stain-positive material both inside the cavity extensively deposited within walls. These consistent pulmonary amyloidoma.SummaryThough rare, amyloidomas be found large cavitating lesions amongst systemic In patient, they serve nidus infections appear similar pneumonias, resulting delays diagnosis. Heart course. A amyloidoma. Though
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ژورنال
عنوان ژورنال: Journal of Heart and Lung Transplantation
سال: 2022
ISSN: ['1053-2498', '1557-3117']
DOI: https://doi.org/10.1016/j.healun.2022.01.1707