CTICasesMedullary Thyroid Carcinoma-associated Amyloidosis and Pulmonary Cysts
Imaging findings
Chest CT scans spanning a five-year period demonstrate a progressive increase in the size and number of multiple small, thin-walled pulmonary cysts. The cysts demonstrate a distinct perivascular distribution, mimicking lymphocytic interstitial pneumonia (LIP) or light chain deposition disease, in a patient with biopsy-proven metastatic medullary thyroid carcinoma.
Key takeaways
Medullary thyroid carcinoma classically secretes calcitonin, which can lead to the systemic deposition of amyloid fibrils (calcitonin-derived amyloidosis). Deposition of amyloid around the bronchovascular bundles can disrupt the local lung matrix or cause a valvular bronchiolar obstruction, leading to the progressive formation of perivascular cysts.
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