CTICasesAL-Type Pulmonary Amyloidosis (Diffuse Alveolar Septal / Nodular and Cystic)
Imaging findings
High-resolution chest CT shows extensive, diffuse, and confluent parenchymal abnormalities including ground-glass opacities, multiple solid nodules, and scattered cystic spaces. Delayed enhancement cardiac MRI shows prominent enhancement within the extensive pulmonary mass-like amyloid deposits, corresponding to the extracellular accumulation of gadolinium.
Key takeaways
AL (primary) amyloidosis is a clonal plasma cell proliferative disorder that can lead to extracellular deposition of monoclonal light chain proteins in various organs. Pulmonary involvement can manifest in multiple patterns, including diffuse alveolar septal, nodular, or tracheobronchial disease, and can even feature cystic spaces. On MRI, amyloid deposits typically display marked delayed enhancement with gadolinium due to expanded extracellular volume, which can help characterize these deposits.
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