Amyloidosis concurrently involving the sinonasal cavities and larynx

Abstract

Localized amyloidosis is an uncommon benign disorder. The purpose of this report is to present the case of a 21-year-old man who had localized amyloidosis simultaneously involving the sinonasal cavities and the larynx. The rarer sinonasal lesion demonstrated CT findings of adjacent "fluffy" bone changes, possibly representing a new finding suggestive of this disorder. At MR imaging, the amyloid had signal intensity similar to that of skeletal muscle on T1- and T2-weighted images. After contrast material administration, the amyloid enhanced at most minimally, but peripheral enhancement about the mass was present. The importance of this case lies in the multifocal presentation of this uncommon disorder, and the imaging findings herein may provide a new sign of this paranasal sinus disease.

Fig 1.

A, Coronal CT viewed at wide window settings shows fluffy calcifications (arrows) of the turbinates and sinus walls adjacent to a nasal mass. Soft tissue windowing shows entrapped secretions and inflammatory mucosal thickening in the right maxillary and sphenoid sinuses. B, Axial T2-weighted MR image (TR/TE, 3000/96 ms) through the paranasal sinuses, demonstrates a predominantly hypointense lesion (arrows) involving the right sinonasal cavity. In contrast, entrapped secretions in the right maxillary and sphenoid sinuses have high T2-weighted signal intensity. C, Contrast-enhanced, axial fat-suppressed T1-weighted image (TR/TE, 540/12 ms) demonstrates peripheral enhancement of the lesion (arrows).

Fig 2.

A, Coronal T1-weighted image through the larynx demonstrates a mass (arrows) involving the left false vocal cord with hypointensity similar to adjacent muscle. The lesion also has low signal intensity on T2-weighted images (not shown). B, Contrast-enhanced axial T1-weighted, fat-suppressed image demonstrates a minimally enhanced submucosal lesion (arrow) surrounded by intense mucosal enhancement.