Abstract
RATIONALE: This section discusses the etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of primary nodular pulmonary amyloidosis. PATIENT CONCERNS: We conducted a retrospective analysis of a 60-year-old female patient at Shanghai Chest Hospital who was diagnosed with primary polymorphic pulmonary amyloidosis following the detection of pulmonary nodules during a chest computed tomography (CT) scan as part of a routine physical examination. The analysis encompassed clinical symptoms, imaging and laboratory findings, bronchoscopy results, and medication history. DIAGNOSIS: Primary nodular pulmonary amyloidosis. INTERVENTIONS: The patient presented no clinical symptoms. A chest CT scan performed during physical examination revealed pulmonary nodules. These nodules were located extra-luminal. Pathological tissue was obtained via transbronchial needle aspiration under bronchoscopic guidance, utilizing a combination of cone beam computed tomography and rpEBUS. Pathological findings demonstrated polymorphic plasma cell infiltration and multinucleated giant cell proliferation within the pulmonary interstitium, accompanied by deposition of eosinophilic amorphous material. Congo red staining yielded a positive result. OUTCOMES: Primary nodular pulmonary amyloidosis lacks specific clinical and imaging manifestations and requires pathological examination and Congo red staining to confirm the diagnosis. There is no recognized treatment option, but early diagnosis and treatment have a certain role in prognosis. LESSONS: Primary nodular pulmonary amyloidosis may present asymptomatically and requires confirmation through a rigorous diagnostic process. Although treatment options are limited, early detection remains crucial for optimizing patient prognosis.