Pleural amyloidosis

Last revised by David Luong on 27 Jul 2021

Amyloidosis involving the pleura is a very uncommon manifestation of thoracic amyloidosis estimated to only occur in 1-2% of patients with systemic amyloidosis 1.

Radiographic features

CT 

Non-specific and when present, pleural amyloid involvement has typically been discovered due to recurrent or persisting pleural effusions leading to eventual diagnosis on pleural biopsy. Presentation as mass-forming pleural thickening detectable on imaging is considered extremely unusual. 

Differential diagnosis

Where it manifests as pleural thickening it is difficult to distinguish radiologically from entities such as mesothelioma or other pleural malignancies.

When it presents as a pleural effusion, it carries a wide differential.

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