Primary nodular or tumefactive amyloid disease of the lower respiratory tract is a rare condition first described by Balser1 in 1883. Localized amyloid disease, as an isolated primary entity, has been reported occurring in many sites: mouth, pharynx, larynx, trachea and bronchi, ureter and bladder, choroid plexus, myocardium, skin, stomach, muscle, and bone. In the respiratory tract Whitwell2 reported the order of frequency as: larynx, trachea, and pharynx; deposits in the lower respiratory tract are rare. Primary localized tumor-forming amyloidosis of the respiratory tract is to be distinguished from the primary systemic form of amyloidosis in which bronchopulmonary deposits may be found. Shottenfeld3 in 1951 summarized 14 cases of primary amyloid disease limited to the lower respiratory tract, including one of his own.
The present case is reported because of its rarity and to call attention to features not previously cited: (1) recurrent middle lobe syndrome
KRONSCHNABEL EF, LANDIS FB. Primary Amyloid Tumor: Cause of Middle Lobe Syndrome. Arch Otolaryngol. 1962;76(3):233–238. doi:10.1001/archotol.1962.00740050241008
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