Document Detail

Amiodarone-related pulmonary mass and unique membranous glomerulonephritis in a patient with valvular heart disease: Diagnostic pitfall and new findings.
MedLine Citation:
PMID:  18801087     Owner:  NLM     Status:  MEDLINE    
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.
Tokuhiro Kimura; Shigeru Kuramochi; Takaharu Katayama; Tsutomu Yoshikawa; Taketo Yamada; Yoshihiko Ueda; Yasunori Okada
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pathology international     Volume:  58     ISSN:  1440-1827     ISO Abbreviation:  Pathol. Int.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-19     Completed Date:  2008-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431380     Medline TA:  Pathol Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  657-63     Citation Subset:  IM    
Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
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MeSH Terms
Amiodarone / adverse effects*
Anti-Arrhythmia Agents / adverse effects*
Cytoplasm / drug effects,  ultrastructure
Diagnostic Errors*
Fatal Outcome
Foam Cells / drug effects,  ultrastructure
Glomerulonephritis, Membranous / chemically induced*,  diagnosis
Heart Valve Diseases / complications,  drug therapy*,  pathology
Hemosiderin / metabolism
Lung / drug effects,  metabolism,  pathology
Lung Diseases / chemically induced*,  diagnosis,  metabolism
Lung Neoplasms / diagnosis
Lymphocytes / pathology
Plasma Cells / pathology
Proteinuria / chemically induced,  diagnosis
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone; 9011-92-1/Hemosiderin

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