Amyloidosis: Review and CT Manifestations

Christos S. Georgiades, MD, PhD ; Edward G. Neyman, MD ; Matthew A. Barish, MD ; Elliot K. Fishman, MD

1 From the Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287 (C.S.G., E.G.N., E.K.F.); and the Department of Radiology, Brigham and Women’s Hospital, Boston, Mass (M.A.B.). Presented as an education exhibit at the 2002 RSNA scientific assembly. Received April 23, 2003; revision requested May 19 and received July 8; accepted July 11. All authors have no financial relationships to disclose.

Amyloidosis is a collection of disease entities that produce considerable morbidity and mortality and are increasing in prevalence. The imaging findings are problematically nonspecific and diverse. This lack of specificity is compounded by the fact that amyloidosis is strongly associated with and frequently coexists with many other chronic disease states that have their own imaging findings. Amyloidosis can involve any organ singly or in conjunction with other organs and can do so in the form of a focal, tumorlike lesion or an infiltrative process. In the proper clinical setting, that is, in a patient with chronic inflammatory disease and especially in a patient with multiple myeloma, amyloidosis should be considered as a possible cause of worsening or new symptoms or imaging findings. Occasionally, the radiologic findings may precede the clinical findings, thus providing the radiologist with the opportunity to contribute to the patient’s care. However, to make a difference in patient care, the radiologist must be familiar with the diverse imaging findings of amyloidosis as well as the patient’s clinical history, which could raise the suspicion of amyloidosis.