Lung cancer combined with diffuse peritoneal and mesenteric amyloidosis detected on 18F-FDG PET/CT: A case report

Medicine (Baltimore). 2021 May 28;100(21):e25961. doi: 10.1097/MD.0000000000025961.

Abstract

Rationale: Amyloidosis is a heterogeneous group of diseases characterized by extracellular deposition of amyloid fibrils. Lung carcinoma is rarely reported to be associated with AA amyloidosis. With regard to the manifestation of amyloidosis infiltrating organs, most of the cases focus on the heart, liver, kidneys, and peripheral nervous system. Amyloidosis with diffuse abdominal involvement in combination with pulmonary squamous cell carcinoma carcinoma is an exceptionally rare occurrence.

Patient concerns: A 70-year-old man was admitted to hospital for a 2-month history of repeated cough, low grade fever, hemoptysis and left back shoulder pain, which was not relieved by nonsteroid anti-inflammatory drugs. Meanwhile, he complained of intermittent diffuse abdominal discomfort and chronic persistent constipation.

Diagnoses: The patient was diagnosed with poorly differentiated lung squamous cell carcinoma and diffuse peritoneal and mesenteric amyloidosis based on the pathological biopsy.

Interventions: The patient received surgery and chemotherapy for lung tumor. He did not receive any treatment against amyloidosis.

Outcomes: The patient died of a severe respiratory infection.

Lessons: This case indicates that lung carcinoma is suspected to play a causative role in the development of amyloidosis. In addition, amyloidosis should be considered in the differential diagnosis in cases in which diffuse greater omentum, peritoneal, and mesenteric calcifications on 18F-2-fluoro-2-deoxy-D-glucose(18F-FDG) photon emission computed tomography (PET/CT).

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloidosis / diagnosis*
  • Amyloidosis / etiology
  • Amyloidosis / pathology
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / therapy
  • Chemotherapy, Adjuvant
  • Fatal Outcome
  • Fluorodeoxyglucose F18 / administration & dosage
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Lung / surgery
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / therapy
  • Male
  • Mesentery / diagnostic imaging
  • Mesentery / pathology
  • Omentum / diagnostic imaging
  • Omentum / pathology
  • Pneumonectomy
  • Positron Emission Tomography Computed Tomography / methods*

Substances

  • Fluorodeoxyglucose F18