S D Med. 2026 May;79(suppl 5):s30-s31.
ABSTRACT
INTRODUCTION: Amyloidosis comprises a group of disorders characterized by extracellular deposition of misfolded amyloid proteins within tissues and organs. Tracheobronchial amyloidosis is a rare form of localized amyloidosis involving deposition within the tracheobronchial tree and often presents with nonspecific respiratory symptoms that can mimic more common pulmonary diseases. Because of its rarity and variable presentation, diagnosis may be delayed. Increased awareness of this condition is important to facilitate timely recognition and management.
CASE REPORT: A 49-year-old male presented to a pulmonology clinic with a nine-month history of intermittent cough and hemoptysis. Episodes were characterized by sore throat followed by nonproductive cough, wheezing, dyspnea during coughing spells, and blood-tinged sputum. Symptomatic episodes lasted several weeks and recurred three times over nine months. Prior treatment with antibiotics, corticosteroids, and bronchodilators provided partial relief. Chest radiography demonstrated mild hyperinflation without acute findings, and physical examination revealed rhonchi. Computed tomography of the chest demonstrated irregular thickening of the anterior tracheal wall with calcifications near the level of the aortic arch. Subsequent bronchoscopy revealed a friable papillomatous lesion nearly obstructing the mid-trachea. Biopsy was negative for acid-fast and fungal organisms. Histopathology demonstrated amyloid deposition with apple-green birefringence on Congo red staining. The patient underwent rigid bronchoscopy with successful soft tissue debulking. Follow-up bronchoscopy two months later showed a normal airway without recurrence, and evaluation revealed no evidence of systemic amyloidosis.
CONCLUSION: Tracheobronchial amyloidosis is an uncommon cause of chronic cough and hemoptysis that may mimic other airway diseases. Recognition of characteristic imaging and bronchoscopic findings, along with confirmatory Congo red staining, is essential for diagnosis. Early bronchoscopic intervention can restore airway patency and improve symptoms.
PMID:42525996