MediAI

  Nodular Pulmonary Amyloidosis | Calcified Lung Nodule | Spiculation | FDG PET/CT | SUVmax 4.7 | AL Kappa Amyloidosis Author: Dr. HJ Lee Executive Answer Nodular pulmonary amyloidosis is a rare form of localized pulmonary amyloid deposition that can closely mimic primary lung cancer on CT and FDG PET/CT. In this case, a woman in her 70s undergoing evaluation for arrhythmia was found to have an approximately 2-cm left apical, pleural-adjacent pulmonary nodule with spiculated margins and eccentric calcification. FDG PET/CT demonstrated increased uptake with an SUVmax of 4.7. Although these findings raised substantial concern for malignancy, the final diagnosis was nodular pulmonary amyloidosis, specifically kappa-type AL amyloidosis. The key lesson is that calcification, spiculation, and FDG uptake must be interpreted together rather than treated as independent proof of cancer. Why This Case Matters A calcified pulmonary nodule is not automatically benign. That principle is particul...