Nodular pulmonary amyloidosis

Case contributed by Dr R Mannava

Presentation

Incidental pulmonary nodules discovered on chest radiograph. The patient is asymptomatic.

Patient Data

Age: 73
Gender: Female

Initial radiograph

X-ray

Multiple differently sized pulmonary nodules, some of which are calcified as seen on the dual-energy subtraction radiograph.

CT 5 years later

CT

Numerous, irregular pulmonary nodules of varying sizes and varying degrees of calficiation. Some of the nodules are cavitary. They are distributed randomly throughout both lungs.

7 years after presentation

X-ray

Numerous calcified pulmonary nodules are increased from 7 years prior.  Interval radiographs (not shown) show slow progression in size, number, and degree of calcification of the nodules.

Case Discussion

This is a pathologically proven case. Biopsy of one of the lung nodules revealed amyloidosis.  The slow progression over seven years also is consistent with the diagnosis.

Differential diagnoses of calcifying metastases, granulomatous disease, or inhalational lung disease are not consistent with the findings and slow progression.

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