Question 1589
{"accessible":true,"alternatives":[{"id":7914,"text":"actinomycosis"},{"id":7915,"text":"amyloidosis"},{"id":7916,"text":"multicentric Castleman disease"},{"id":7917,"text":"sarcoidosis"},{"id":7918,"text":"tuberculosis"}],"archived":false,"correctAlternativeId":7915,"explanation":"\u003cp\u003eWhen\u0026nbsp;amyloid proteins fold incorrectly they may form fibrils and sheets that are not broken down intracellularly and instead are deposited in extracellular tissues. The appearance is protean and it can strike virtually any part of the body. Clinically, and in imaging, it can share similarities to leukemia and myeloma. Biopsy is usually necessary to differentiate.\u003c/p\u003e\u003cp\u003eThis patient's CT shows a diffusely enhancing mass in the left hepatic lobe, although amyloidosis can present in the liver as either hyper- or hypoenhancing. There diffusely low signal in the spinal bone marrow with a T12 compression injury.\u003c/p\u003e\u003cp\u003eHer liver biopsy (and a subsequent bone marrow biopsy) showed light chain amyloidosis.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eImage credit:\u0026nbsp;\u003c/strong\u003eMatthew A Morgan\u003c/p\u003e","id":1589,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/124/Slide1_big_gallery.jpeg","imageAttribution":{"kind":"own","user_id":35959,"user_param":"crushergradient","user_name":"Matt A. Morgan"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2839","nextQuestionPath":"/articles/tuberculosis/questions/1563","relatedArticles":[{"id":6720,"title":"Amyloidosis","link":"/articles/amyloidosis?lang=us"},{"id":10339,"title":"Castleman disease","link":"/articles/castleman-disease?lang=us"},{"id":2019,"title":"Sarcoidosis","link":"/articles/sarcoidosis-1?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 45-year-old woman began to experience severe back pain and had a long history of abdominal pain. Subsequent workup included a spine MRI, a CT,\u0026nbsp;and a liver biopsy shortly afterwards. A contrast-enhanced CT image of her abdomen and a sagittal T1 image of her spine is provided below. What is the most likely diagnosis from the list below?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1589"}],"attemptsPercentages":[{"alternativeId":"7915","percentage":33},{"alternativeId":"7916","percentage":23},{"alternativeId":"7914","percentage":3},{"alternativeId":"7918","percentage":30},{"alternativeId":"7917","percentage":11}],"promptToLogin":false,"questionManager":false,"articleId":"tuberculosis"}