Pulmonary amyloidosis: A case series

Area of Science:

• Pulmonology
• Pathology
• Radiology

Background:

• Amyloidosis is a group of diseases characterized by extracellular deposition of misfolded proteins as beta-pleated sheets.
• Amyloid light-chain amyloidosis, a common subtype, often presents with multisystemic involvement, affecting approximately 50% of patients in the lungs.
• Computed tomography (CT) of the chest reveals three primary patterns of pulmonary amyloidosis: tracheobronchial, nodular parenchymal, and diffuse alveolar septal.

Observation:

• This report details two cases of pulmonary amyloidosis.
• One case illustrates diffuse alveolar septal pulmonary amyloidosis, an exceptionally rare manifestation with a grave prognosis.
• The second case presents the tracheobronchial pattern, typically caused by localized amyloid deposition within the airways.

Findings:

• Diffuse alveolar septal pulmonary amyloidosis is an extremely rare pattern with a poor prognosis.
• Tracheobronchial amyloidosis involves localized deposition in the airways.
• Pulmonary amyloidosis often exhibits nonspecific findings on CT chest, complicating diagnosis.

Implications:

• Increased awareness of pulmonary amyloidosis is crucial for timely diagnosis and management.
• Recognizing rare patterns like diffuse alveolar septal involvement is vital for prognostic accuracy.
• Understanding the varied CT manifestations of pulmonary amyloidosis aids in differentiating it from other lung diseases.