• Amyloidosis is a
  • characterized by the deposition of
  • abnormal protein aggregates called amyloid

Structural Involvement

• Trachea and Bronchi
• Pulmonary Vasculature
• Lung Parenchyma
• Pleura
• Lymph Nodes
• Mediastinum 

Findings

Imaging Finding	Description
Tracheobronchial Involvement:	Amyloid deposits in the trachea and bronchi, leading to wall thickening and luminal narrowing.
Submucosal Deposits:	Amyloid deposits beneath the mucosa of the trachea and bronchi, contributing to airway compromise.
Nodular or Mass-like Lesions:	Formation of nodules or mass-like lesions in the lung parenchyma due to amyloid deposits.
Pulmonary Parenchymal Involvement:	Amyloid deposition in the lung parenchyma, leading to diffuse or focal interstitial infiltrates.
Ground-Glass Opacities (GGOs):	Areas of ground-glass opacities on imaging studies, reflecting parenchymal involvement.
Septal Thickening
Pleural Involvement:	Amyloid deposition in the pleura, leading to pleural thickening or effusion in some cases.
Mediastinal Lymphadenopathy:	Enlarged lymph nodes in the mediastinum,  due to amyloid deposits can calcify.

• Involvement of the mediastinum, including lymph nodes, may occur in some cases of amyloidosis.
• Extracellular deposition
  • insoluble proteins
  • Lung

  • 

    

    

    

    • Tracheobronchial
      • concentric airway thickening,
      • mural and intraluminal nodules,
      • submucosal calcification, and
      • airway obstruction

      • 

        

        

        

    • Parenchyma
      • Mass Like that may 
        • calcify,
        • cavitate, and
        • slowly enlarge.

• Nodular Form that may
  • • calcify,
    • cavitate, and
    • slowly  enlarge.

    • 

      

      • 
      • Multiple parenchymal nodules that may
        • • calcify,
          • cavitate, and
          • slowly enlarge.
        • 
      • Alveolar septal pulmonary amyloidosis
      • Diffuse reticulonodular interstitial thickening,
      • Alveolar septal pulmonary amyloidosis is
        • less common
        • clinically more important than the nodular parenchymal form.
        • more commonly symptomatic
        • more likely to progress to pulmonary hypertension and respiratory failure
        • systemic involvement,
          • an independent predictor of poor survival,
        • more common in this subtype.

• • • • 
      • consolidations, or
      • Nodular form
        • solitary or
      • Pleural involvement most commonly manifests as
        • pleural effusions.
        • nodules
          • 

            

            

            

            

            

  • Mediastinal and hilar lymph nodes may
    • • • enlarge and
        • frequently calcify.

        • 

          

          

          

          Soft Tissue Infiltration
          

          

          

          

          

  • Associated with Cysts
    •  Uncommon
      • lower lobes
      • peribronchovacsular disease
    • often in patients with
      • systemic amyloidosis due to
      • Sjögren syndrome (21).
    • may be associated with
      • calcified nodules or
      • noncalcified nodules.
    • cysts may be a
      • manifestation of lymphocytic interstitial pneumonia in Sjögren syndrome
      • or a manifestation of amyloidosis (possibly due to small airway obstruction by amyloid deposits)

 

 

NODULAR FORM OF PULMONARY AMYLOIDOSIS
67 year old female with a nodular form of pulmonary amyloidosis characterised parenchymal calcified nodules, many of which have cystic changes around the nodules.
Courtesy Geraldine Tran MD

Likely Sjogren’s Cystic Lung Disease and Amyloid 

 

References and Links

Radiopaedia

Czeyda-Pommersheim F etal  Amyloidosis: Modern Cross-sectional Imaging Radiographics  Vol. 35, No. 5

• TCV
  • Faces of Amyloidosis
  • Case Studies
  • 014Lu Nodular Parenchymal Amyloid and Cystic Changes
    • 014Lu Nodular Parenchymal Amyloid and Cystic Changes
    • 037Lu Amyloidosis of the Trachea and Bronchi
    • 038Lu Amyloidosis Hilar Lymph Nodes Pericardium CAD
      66Lu Amyloid nodules alveolar septal and bronchiole and MAC 
    • 89Lu Amyloid Calcified Mass and Pleural Involvement
    • 68Lu  Trachea Amyloid
    • 70Lu Amyloid Consolidative Nodular Septal
    • 89Lu Amyloid Calcified Mass and Pleural Involvement
      90Lu Amyloid Interstitial and Calcified Micronodules
      92 LU Amyloid Lung and Heart