Pulmonary light-chain deposition disease: CT and pathology findings in nine patients

Clin Radiol. 2015 May;70(5):515-22. doi: 10.1016/j.crad.2015.01.002. Epub 2015 Feb 7.

Abstract

Aim: To review the clinical features of nine patients with pulmonary light-chain deposition disease (LCDD) and record their high-resolution CT (HRCT) and histopathological findings.

Materials and methods: Patients with a diagnosis of LCDD on lung biopsy specimen were retrospectively identified. The HRCT characteristics of nodules, cysts, and ancillary findings; change at follow-up; and histopathological findings were documented.

Results: Features common to all nine cases were thin-walled cysts. In seven cases, vessels traversing the cysts were identified. The majority of patients (8/9) had at least one pulmonary nodule. There was no zonal predominance of either cysts or nodules. The disease appeared stable in the majority of cases with no serial change in HRCT appearances (5/6 cases with follow-up data, mean duration 29 months).

Conclusion: To the authors' knowledge, this is the largest series of pulmonary LCDD patients in the literature, and the first systematic assessment of HRCT findings. Pulmonary cysts are a unifying feature, usually with pulmonary nodules, and serial change on HRCT is unusual.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Humans
  • Immunoglobulin Light Chains*
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / pathology
  • Male
  • Middle Aged
  • Paraproteinemias / diagnostic imaging*
  • Paraproteinemias / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Immunoglobulin Light Chains