CTICasesDiffuse Pulmonary Calcifications in Alveolar Septal Amyloidosis
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Imaging findings
Chest CT shows bilateral atelectasis, centrilobular opacities, and extensive pulmonary calcifications. The calcifications are diffuse, some appearing nodular and some inseparable, concentrated towards the central areas of the lungs. Ground-glass opacities are also present, which are not of high attenuation to suggest calcification and may represent hemorrhage. Cardiac imaging reveals left atrial dilatation but no pericardial effusion. Some mediastinal lymph nodes are noted.
Key takeaways
Alveolar septal amyloidosis, particularly in patients with end-stage renal disease and systemic amyloidosis, can manifest with widespread pulmonary calcifications, often described as "pulmonary dandruff" or dentiform opacities. The calcifications can be nodular and extensive. Associated ground-glass opacities might indicate alveolar hemorrhage. Cardiac involvement is common in systemic amyloidosis.
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