Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pulmonary Amyloidosis
- Radiologic Findings
- Chest radiography shows multiple small nodules in bilateral lung fields (Fig. 1). Contrast-enhanced chest CT images (Fig. 2 A and B) with a mediastinal window set show multiple irregular high-attenuation nodules (size range, 1-2 cm) in bilateral lungs. The lower lobe of left lung has severe bronchial stenosis with small high-attenuation nodule (Fig. 2A). When reviewed the chest CT images (Fig. 2 C and D) taken at 2018 and 2013, the heterogeneous lesion in the lower lobe of right lung has remarkable enlargement of high-attenuation components.
- Brief Review
- Amyloidosis refers to a group of conditions characterized by extracellular deposition of abnormal protein and protein derivatives. The vast majority of cases of amyloidosis fall into two distinct classes: 1) primary amyloid light chain disease (with immunoglobulin light chains by plasma cell) and 2) secondary amyloid A chain disease . The primary amyloid light chain disease (with chronic inflammatory disorders).
Primary systemic amyloidosis usually results in a reticulonodular pattern due to diffuse interstitial parenchymal involvement on radiograph. This appearance must be differentiated from the finding of increased reticular markings and prominent interlobular septa resulting from congestive failure due to cardiac amyloidosis. On chest CT images, we have noticed that the abnormal areas by amyloidosis can calcify or, rarely, show frank ossification. In addition, the localized form of amyloidosis may manifest as single or, less commonly, multiple lung nodules or masses (nodular parenchymal amyloidosis), or as thickening and calcification of airway walls (tracheobronchial amyloidosis).
- References
- 1. Ayuso MC, Gilabert R, Bombi JA, et al. CT appearance of localized pulmonary amyloidosis. J Comput Assist Tomogr1987;11:197–199.
2. Pickford HA, Swensen SJ, Utz JP. Thoracic cross-sectional imaging of amyloidosis. AJR Am J Roentgenol1997;168:351–355.
- Keywords
- Lung,