ABSTRACT
Metastatic lung tumor was suspected in a 52-year-old woman who showed multiple nodules on her chest radiographs. Conventional examinations did not define the diagnosis, and so a biopsy was performed using video-assisted thoracoscopic surgery. Pathological examination demonstrated deposits of amorphous materials which were stained red by Congo red staining, even after potassium permanganate treatment. Green birefringence was also observed in the deposits under a polarized light microscope. A diagnosis of localized pulmonary amyloidosis with AL type amyloid protein was made, and therapy with dimethyl sulfoxide (10 ml/day) was started. During the two-year therapy, little exacerbation on pulmonary nodules was observed. It was suggested that dimethyl sulfoxide inhibited the progression of the disease.
Subject(s)
Amyloidosis/drug therapy , Dimethyl Sulfoxide/therapeutic use , Lung Diseases/drug therapy , Amyloidosis/diagnosis , Biopsy , Female , Humans , Lung/pathology , Lung Diseases/diagnosis , Middle Aged , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Eosinophil transendothelilal migration across vascular endothelial cells is an initial step of eosinophil accumulation in allergic inflammation. There is increasing evidence that specific immunotherapy (SIT) modulates the production of inflammatory molecules from mononuclear cells. OBJECTIVE: The present study was undertaken to examine whether SIT modifies eosinophil transendothelial migration induced by the supernatants of antigen-stimulated mononuclear cells from atopic asthmatics. METHODS: Dermatophagoides farinae (Df)-sensitive mild persistent asthmatics were divided into a SIT-treated group and a control group. Peripheral blood mononuclear cells (PBMC) were isolated before and after SIT using the rush protocol, and cultured for 96 h at 37 degrees C in the presence or absence of Df antigen. Eosinophils were isolated from the blood of healthy subjects, and put on transwell filters coated with pulmonary microvascular endothelial cell monolayers stimulated with IL-4 plus TNF-alpha. The supernatants of PBMC were applied to the lower compartment and the transmigration of eosinophils was examined. RESULTS: Df stimulation of PBMC resulted in an augmentation of eosinophil transendothelial migration. This enhancement was abrogated following SIT. In the control group, the antigen-induced effect on eosinophil transmigration did not show an interval change. CONCLUSION: SIT attenuates eosinophil transendothelial migration induced by antigen-stimulated mononuclear cells.
Subject(s)
Asthma/therapy , Chemotaxis, Leukocyte/drug effects , Eosinophils/drug effects , Immunotherapy , Adult , Antigens, Dermatophagoides/immunology , Asthma/immunology , Chemotactic Factors, Eosinophil/pharmacology , Endothelium, Vascular/metabolism , Eosinophils/physiology , Female , Humans , Leukocytes, Mononuclear/immunology , Male , Middle AgedABSTRACT
The presence of multiple small nodular shadows on a routine chest radiograph was noticed in a 56-year-old woman who had undergone a left mastectomy on the diagnosis of breast cancer 8 years before. Chest CT films revealed small nodules scattered beneath the pleura mainly in both lower lobes. A biopsy was performed during video-assisted thoracoscopy to rule out metastasis from breast cancer. Biopsy specimens showed spindle--or oval-shaped cells arranged in nests associated with a dedicated network of capillaries. These findings were compatible with minute meningothelium-like nodules (MN). The pathogenesis of MN is still unknown. It is common in elderly women, and the prognosis is excellent without any treatment. MN is an important disease in the differential diagnosis of multiple nodular shadows found on chest CT.
