The spectrum of amyloidosis was studied in 223 patients examined at autopsy at The Johns Hopkins Hospital since 1889. Of these patients, pulmonary involvement with amyloid was found in 68 patients including 31 with senile cardiac amyloidosis, 23 with primary amyloidosis, eight with myeloma associated amyloidosis, two with familial amyloidosis with polyneuropathy, three with isolated nodular pulmonary parenchymal amyloidosis and only one patient with secondary amyloidosis. The degree of pulmonary involvement ranged from either focal parenchymal or vascular amyloid to severe diffuse parenchymal and vascular amyloid. In general, cardiac amyloid involvement tended to parallel the pulmonary involvement and usually was more severe. Correlations between pulmonary amyloidosis and cardiac amyloidosis were statistically significant. Patients with primary amyloidosis, senile cardiac amyloidosis, myeloma associated amyloidosis, nodular pulmonary amyloidosis and familial amyloidosis with polyneuropathy had potassium permanganate-resistant amyloid. These findings suggest that the amyloid in these types of amyloidosis, in which pulmonary involvement is frequent, is a protein of either immunoglobulin origin or of a similar structure.
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