Vascular amyloidosis causing spontaneous mediastinal haemorrhage with haemothorax

Bleeding diathesis is a recognised complication of amyloid disease. Localis ed and generalised bleeding manifestations are usually associated with intr avascular coagulopathy related to isolated or Multiple coagulation factor d eficiencies. Recently, there have been reports of haemorrhage due to amyloi d deposition in blood vessel walls and in the perivascular region leading t o increased fragility and poor haemostasis. We report a case of spontaneous mediastinal haemorrhage due to amyloid involvement of vascular tissue in t he absence of coagulopathy. (C) 2001 Elsevier Science B.V. All rights reser ved.