CTICasesSystemic Amyloidosis (Amyloidomas) Secondary to Waldenström's Macroglobulinemia
Imaging findings
Chest and abdominal CT scans show a large, lobulated soft-tissue mass with coarse, chunky calcifications in the right cardiophrenic angle/anterior mediastinum, as well as extensive, infiltrative retroperitoneal and mesenteric soft-tissue thickening surrounding the pancreas and both kidneys. PET/CT demonstrates low-grade metabolic activity within these lesions. Biopsies of both the mediastinal and perirenal masses demonstrate amorphous deposits that are Congo red positive, confirming amyloidomas.
Key takeaways
Waldenström's macroglobulinemia, a lymphoplasmacytic lymphoma, can be associated with systemic AL amyloidosis and localized amyloid tumor deposits (amyloidomas). Amyloidomas can occur in the mediastinum, retroperitoneum, and lung parenchyma, often presenting as slow-growing, calcified or ossified mass-like lesions that mimic lymphoma, retroperitoneal fibrosis, or other neoplastic processes on CT.
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