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대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 72 Date 1999-03-13

  • Courtesy of Tae Sung Kim, MD, Kyung Soo Lee, MD / Samsung Medical Center, Seoul, Korea
  • Age/Sex 43 / M
  • Chief ComplaintMild dyspnea on exertion for one month. The patient had no extrathoracic malignancy. CT scans with mediastinal window setting (not shown here) demonstrated subtle high attenuation within the nodules, suggesting calcification of the nodules. What would be the most probable differential diagnosis?
  • Figure 1
  • Figure 2

Diagnosis With Brief Discussion

Diagnosis
Pulmonary Amyloidosis
Radiologic Findings
Diffuse centrilobular micronodules with branching linear structures, nodular interlobular septa, nodular irregularity of vessels, subpleural dots, and studded fissures are seen at thin-section CT, which suggest perilymphatic distribution of the disease. On transbronchial lung biopsy specimens, amyloid was seen in the interlobular septa and beneath the visceral pleura as well as within the walls of the bronchiole.
Diffuse micronodular diseases with perilymphatic distribution include sarcoidosis, lymphangitic carcinomatosis, amyloidosis, and sometimes pneumoconiosis.
Brief Review
References
Lee KS, Kim TS, Hwang JH, et al. Diffuse micronodular lung diseases: thin-section CT and pathologic findings. JCAT (1999 in press )
Keywords
Lung, Interstitium, Metabolic and storage lung disesae,

No. of Applicants : 25

▶ Correct Answer : 11/25,  44.0%
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▶ Semi-Correct Answer : 7/25,  28.0%
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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