"Spirometric" lung age reference equations: A narrative review.

The aim of the present paper was to conduct a narrative review of the published norms of the "spirometric" lung-age (SLA). A literature search which covered the period 1970 to June 2017, was conducted using the Pubmed. The search strategy had used the following MeSH words: "Spirometry"[Majr]) AND "Aging"[Majr]. Six original studies have reported equations predicting SLA for adults aged 18-90 years [USA (n=2), Japan (n=2); Australia (n=1) and Tunisia (n=1)]. Their sample sizes varied from 125 to 15238, with a total of 32334 volunteers (11788 men). Several models of norms were developed. They included one (often, FEV1) or more spirometric data in addition to one (often, height) or more anthropometric data. All studies have validated their norms in additional one or more groups, with satisfactory results. Only three authors have proposed algorithms to interpret SLA. All studies presented several limitations concerning the sample size and/or representation, the age distribution, the use of old spirometric data and/or equipment, the application of old spirometric methods, and especially mathematical and statistical flaws.

Systemic Al amyloidosis of the tracheobronchial tract and lungs: a rare finding.

A 67- year old man presented with cough, weight loss and night sweats. Fiberoptic bronchoscopy did not show any abnormality. Chest computed tomography scan revealed peribronchovascular thickening, sheathing and narrowing of some bronchi. There were also mediastinal and interbronchial Lymphadenopathies. The patient became lost to follow-up. He presented 5 years later with pneumonia. Flexible bronchoscopy showed diffuse infiltration of the bronchi suggesting lung cancer. Histopathological study with histochemical staining revealed tracheobronchial tract AL amyloidosis. Chest CT-scan revealed extension of the broncho-vascular thickening and superimposed pulmonary calcified nodules and lymphadenopathies. Labial biopsy revealed AL amyloidosis. No specific treatment of amyloidosis was thought to be necessary for the patient. At 6 years follow-up the disease had not progressed. This case report highlights the fact that even very rarely, systemic AL amyloidosis can involve the tracheobronchial tract. Moreover, the lungs and the tracheobronchial tract can, although rarely, be affected in the same patient.