Finding of tracheobronchial amyloid involvement in fibrobronchoscopy: A case report

Abstract

Amyloidosis is a group of diseases characterized by extracellular deposition of amyloid fibrils, which may be localized or systemic. This report describes the case of a 69-year-old patient, with no previous comorbidities, complaining of asthenia, diarrhea and vomiting, without dyspnea, evolving with worsening of the respiratory pattern, requiring orotracheal intubation and, later, tracheostomy. In the bronchoscopy for evaluation of decannulation, it evidenced tracheobronchial tree with multiple papular lesions in mucosa, some with central ulceration, of diffuse granular aspect, affecting the anterolateral walls of the trachea. Histopathological examination confirmed amyloid staining with Congo Red dye. Tracheobronchial amyloidosis corresponds to 0.5% of symptomatic tracheal lesions, and may manifest with nonspecific symptoms. The investigation should be supported by chest computed tomography and fibrobronchoscopy. The diagnostic confirmation is given through histopathological analysis of the bronchial tissue biopsied through fibrobronchoscopy and positive staining with Congo Red dye.