Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease: Diagnostic pitfall and new findings

Tokuhiro Kimura, Shigeru Kuramochi, Takaharu Katayama, Tsutomu Yoshikawa, Taketo Yamada, Yoshihiko Ueda, Yasunori Okada

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Amiodarone is an anti-arrhythmic drug for life-threatening tachycardia, but various adverse effects have been reported. Reported herein is an autopsy case of valvular heart disease, in a patient who developed a lung mass (1.5 cm in diameter) and proteinuria (2.76 g/day) after treatment with amiodarone for a long time. The lung mass was highly suspected to be lung cancer on CT and positron emission tomography, but histologically the lesion was composed of lymphoplasmacytic infiltrates in alveolar walls and intra-alveolar accumulation of foamy macrophages containing characteristic myelinoid bodies, indicating that it was an amiodarone-related lesion. In addition, the lung tissue had unevenly distributed hemosiderin deposition, and abnormally tortuous capillaries were seen in the mass and in heavily hemosiderotic lung portions outside the mass. In the kidneys, glomeruli had membrane spikes, prominent swelling of podocytes and subepithelial deposits, which were sometimes large and hump-like. Autoimmune diseases, viral hepatitis, malignant neoplasms or other diseases with a known relationship to membranous glomerulonephritis were not found. The present case highlights the possibility that differential diagnosis between an amiodarone-related pulmonary lesion and a neoplasm can be very difficult radiologically, and suggests that membranous glomerulonephritis might be another possible complication of amiodarone treatment.

Original languageEnglish
Pages (from-to)657-663
Number of pages7
JournalPathology International
Volume58
Issue number10
DOIs
Publication statusPublished - 2008 Oct

Fingerprint

Membranous Glomerulonephritis
Heart Valve Diseases
Amiodarone
Lung
Kidney Glomerulus
Hemosiderin
Podocytes
Anti-Arrhythmia Agents
Proteinuria
Tachycardia
Positron-Emission Tomography
Hepatitis
Autoimmune Diseases
Autopsy
Lung Neoplasms
Neoplasms
Differential Diagnosis
Macrophages
Membranes
Therapeutics

Keywords

  • Amiodarone
  • Glomerulonephritis
  • Lung
  • Positron emission tomography
  • Proteinuria

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease : Diagnostic pitfall and new findings. / Kimura, Tokuhiro; Kuramochi, Shigeru; Katayama, Takaharu; Yoshikawa, Tsutomu; Yamada, Taketo; Ueda, Yoshihiko; Okada, Yasunori.

In: Pathology International, Vol. 58, No. 10, 10.2008, p. 657-663.

Research output: Contribution to journalArticle

Kimura, Tokuhiro ; Kuramochi, Shigeru ; Katayama, Takaharu ; Yoshikawa, Tsutomu ; Yamada, Taketo ; Ueda, Yoshihiko ; Okada, Yasunori. / Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease : Diagnostic pitfall and new findings. In: Pathology International. 2008 ; Vol. 58, No. 10. pp. 657-663.
@article{4b2c39d578214656bc7456a90ccb641d,
title = "Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease: Diagnostic pitfall and new findings",
abstract = "Amiodarone is an anti-arrhythmic drug for life-threatening tachycardia, but various adverse effects have been reported. Reported herein is an autopsy case of valvular heart disease, in a patient who developed a lung mass (1.5 cm in diameter) and proteinuria (2.76 g/day) after treatment with amiodarone for a long time. The lung mass was highly suspected to be lung cancer on CT and positron emission tomography, but histologically the lesion was composed of lymphoplasmacytic infiltrates in alveolar walls and intra-alveolar accumulation of foamy macrophages containing characteristic myelinoid bodies, indicating that it was an amiodarone-related lesion. In addition, the lung tissue had unevenly distributed hemosiderin deposition, and abnormally tortuous capillaries were seen in the mass and in heavily hemosiderotic lung portions outside the mass. In the kidneys, glomeruli had membrane spikes, prominent swelling of podocytes and subepithelial deposits, which were sometimes large and hump-like. Autoimmune diseases, viral hepatitis, malignant neoplasms or other diseases with a known relationship to membranous glomerulonephritis were not found. The present case highlights the possibility that differential diagnosis between an amiodarone-related pulmonary lesion and a neoplasm can be very difficult radiologically, and suggests that membranous glomerulonephritis might be another possible complication of amiodarone treatment.",
keywords = "Amiodarone, Glomerulonephritis, Lung, Positron emission tomography, Proteinuria",
author = "Tokuhiro Kimura and Shigeru Kuramochi and Takaharu Katayama and Tsutomu Yoshikawa and Taketo Yamada and Yoshihiko Ueda and Yasunori Okada",
year = "2008",
month = "10",
doi = "10.1111/j.1440-1827.2008.02286.x",
language = "English",
volume = "58",
pages = "657--663",
journal = "Pathology International",
issn = "1320-5463",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease

T2 - Diagnostic pitfall and new findings

AU - Kimura, Tokuhiro

AU - Kuramochi, Shigeru

AU - Katayama, Takaharu

AU - Yoshikawa, Tsutomu

AU - Yamada, Taketo

AU - Ueda, Yoshihiko

AU - Okada, Yasunori

PY - 2008/10

Y1 - 2008/10

N2 - Amiodarone is an anti-arrhythmic drug for life-threatening tachycardia, but various adverse effects have been reported. Reported herein is an autopsy case of valvular heart disease, in a patient who developed a lung mass (1.5 cm in diameter) and proteinuria (2.76 g/day) after treatment with amiodarone for a long time. The lung mass was highly suspected to be lung cancer on CT and positron emission tomography, but histologically the lesion was composed of lymphoplasmacytic infiltrates in alveolar walls and intra-alveolar accumulation of foamy macrophages containing characteristic myelinoid bodies, indicating that it was an amiodarone-related lesion. In addition, the lung tissue had unevenly distributed hemosiderin deposition, and abnormally tortuous capillaries were seen in the mass and in heavily hemosiderotic lung portions outside the mass. In the kidneys, glomeruli had membrane spikes, prominent swelling of podocytes and subepithelial deposits, which were sometimes large and hump-like. Autoimmune diseases, viral hepatitis, malignant neoplasms or other diseases with a known relationship to membranous glomerulonephritis were not found. The present case highlights the possibility that differential diagnosis between an amiodarone-related pulmonary lesion and a neoplasm can be very difficult radiologically, and suggests that membranous glomerulonephritis might be another possible complication of amiodarone treatment.

AB - Amiodarone is an anti-arrhythmic drug for life-threatening tachycardia, but various adverse effects have been reported. Reported herein is an autopsy case of valvular heart disease, in a patient who developed a lung mass (1.5 cm in diameter) and proteinuria (2.76 g/day) after treatment with amiodarone for a long time. The lung mass was highly suspected to be lung cancer on CT and positron emission tomography, but histologically the lesion was composed of lymphoplasmacytic infiltrates in alveolar walls and intra-alveolar accumulation of foamy macrophages containing characteristic myelinoid bodies, indicating that it was an amiodarone-related lesion. In addition, the lung tissue had unevenly distributed hemosiderin deposition, and abnormally tortuous capillaries were seen in the mass and in heavily hemosiderotic lung portions outside the mass. In the kidneys, glomeruli had membrane spikes, prominent swelling of podocytes and subepithelial deposits, which were sometimes large and hump-like. Autoimmune diseases, viral hepatitis, malignant neoplasms or other diseases with a known relationship to membranous glomerulonephritis were not found. The present case highlights the possibility that differential diagnosis between an amiodarone-related pulmonary lesion and a neoplasm can be very difficult radiologically, and suggests that membranous glomerulonephritis might be another possible complication of amiodarone treatment.

KW - Amiodarone

KW - Glomerulonephritis

KW - Lung

KW - Positron emission tomography

KW - Proteinuria

UR - http://www.scopus.com/inward/record.url?scp=51749084888&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=51749084888&partnerID=8YFLogxK

U2 - 10.1111/j.1440-1827.2008.02286.x

DO - 10.1111/j.1440-1827.2008.02286.x

M3 - Article

C2 - 18801087

AN - SCOPUS:51749084888

VL - 58

SP - 657

EP - 663

JO - Pathology International

JF - Pathology International

SN - 1320-5463

IS - 10

ER -