A 46-year-old previously healthy woman presented with recurring left frontal and occipital headache. A brain MRI demonstrated diffuse dural thickening ( figure 1, top). CSF analysis showed no abnormalities. A meningeal biopsy had pathology typical of an amyloid tumor (figure 2). Further investigations did not reveal evidence of plasma-cell tumor, multiple myeloma, systemic amyloidosis, underlying inflammatory disorder, or malignancy. Follow-up brain MRIs revealed regression of the pachymeningeal disease after treatment with corticosteroids and radiotherapy ( figure 1, bottom).Amyloidosis is a group of diseases characterized by the extracellular deposition of amyloid protein.1 Extraaxial locations are rare, 2 but dural amyloidoma should be considered in the differential diagnosis of diffuse meningeal thickening despite the absence of systemic amyloidosis.
A 63-year-old man came to the emergency room complaining of unverified fever and myalgia. Oropharyngeal material was collected for reverse transcription testing followed by polymerase chain reaction (RT-PCR) for coronavirus disease 2019 (COVID-19), and a chest radiography was performed (normal), and the patient was discharged to home isolation, due to his mild symptoms, until the test result. After 3 days, the patient evolved with dyspnea, a drop in oxygen saturation (95%), and measured fever (38.6°C), and a chest computed tomography was performed (Figure 1) and he was admitted to hospital. The RT-PCR test for COVID-19 was positive. Three days later, his respiratory pattern worsened, with a decrease in oxygen saturation to 90%, and he was referred to a stepdown unit and a new tomography was performed (Figure 1). An 80-row CT scanner (Aquillion Prime, Canon Medical Systems, Tochigi, Japan) was used, with the patient in supine position, during maximum inspiration, and without injection of contrast medium. The following parameters were
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