Emphysematous Lung Lesions Caused by Perivascular and Alveolar–Septal Deposition of Amyloid Light-Chain Amyloidosis

Max J. Martin, Kelly M. Pennington, Joseph H. Skalski, Eunhee S. Yi, David L Levin, Urshila Durani, Jay H. Ryu

Research output: Contribution to journalArticlepeer-review

Abstract

Pulmonary amyloidosis, whether isolated or seen as part of systemic amyloidosis, has a variety of radiographic manifestations. Known parenchymal lung findings include reticulonodular opacities, diffuse interstitial infiltrates, or cystic lesions. Here, we present a case of systemic amyloid light-chain (AL) amyloidosis presenting with severe exertional dyspnea and emphysematous lung lesions on chest CT, a finding described only once before. Although factors that influence the pattern of pulmonary amyloid deposition remain unclear, CT image findings typically reflect the histopathologic patterns of deposition. In this case, we hypothesize that the emphysematous changes in the lower lung zones are likely a manifestation of severe alveolar-septal involvement. This case suggests that radiographic findings of pulmonary amyloidosis are not limited to the more common findings of reticular opacities or interstitial infiltrates. Emphysematous changes are possible, and clinicians should maintain a broad differential when seen in the setting of dyspnea.

Original languageEnglish (US)
Pages (from-to)e169-e171
JournalChest
Volume160
Issue number2
DOIs
StatePublished - Aug 2021

Keywords

  • amyloidosis
  • chest imaging
  • emphysema
  • pulmonary
  • pulmonary amyloid

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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