Extensive multifocal and pleomorphic pulmonary lesions in Waldenström macroglobulinemia: A case report

Figure 1 Chest computed tomography examination showing extensive multifocal and pleomorphic lesions in the lungs, including multiple pulmonary cavities, consolidation, ground-glass opacities, patchy infiltrates, fibrous bands, and large bullae. A and B: Upper lung; C: Middle lung; D: Lower lung.

Figure 2 Needle punch biopsy specimen stained with Congo red showing amyloid deposition (magnification, × 200).

Figure 3 Evaluation of needle punch biopsy specimens under a polarizing microscope after Congo red staining showing a typical “apple-green birefringence” of Congo red-stained amyloid (magnification, × 100; U-POT, lens type; Olympus, Tokyo, Japan).

Figure 4 Evaluation of needle punch biopsy specimens by hematoxylin-eosin staining. The specimens were fixed in 10% formaldehyde solution for 6 h, followed by dehydration, clearing, waxing, and sectioning for 4-μm sections. The sections were stained with hematoxylin-eosin and then observed under a light microscope (BX40, Olympus). A large amount of amyloid-like deposition was detected under alveolar epithelial cells (magnification, × 200).