Differential Diagnosis in diffuse pulmonary calcifications.

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Congress:

ECR 2014

Poster Number:

C-1862

Type:

Educational Exhibit

Keywords:

Thorax, Lung, Respiratory system, CT-High Resolution, Conventional radiography, CT, Education, Calcifications / Calculi, Metabolic disorders, Infection

Authors:

H. Devos¹, L. Goethals², Y. De Brucker¹, I. Pilate³, B. Ilsen¹, J. de Mey¹; ¹Brussels/BE, ²Jette, Brussel/BE, ³Mechelen/BE

DOI:

10.1594/ecr2014/C-1862

DOI-Link:

https://dx.doi.org/10.1594/ecr2014/C-1862

Fig. 2: Healed varicella pneumonia. Coronal MIP reconstruction image shows numerous...

Fig. 3: Healed varicella pneumonia. Axial image of the same patient demonstrates no...

Fig. 4: Silicosis. Axial CT scan image obtained using bone window settings shows a...

Learning objectives

To be aware of different causes of diffuse pulmonary calcifications.

Background

Diffuse pulmonary calcifications occur in a wide variety of disorders. Most often these are caused by previous infectious processes. Other known causes are metabolic disorders, occupational disorders or interstitial lung diseases (1). Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Pathophysiologic states predisposing to pulmonary calcification and ossification include hypercalcemia, a local alkaline environment, and previous lung injury. Factors such as enhanced alkaline phosphatase activity, active angiogenesis, and mitogenic effects of growth factors may also contribute...

Findings and procedure details

Imaging The chest radiograph is useful for the detection of pleural calcification, hilar-mediastinal lymph node calcification or calcified lung nodules. However, diffuse calcification is often mistaken for another process such as pulmonary edema or intrapulmonary hemorrhage, as it appears as a non-specific infiltrate. High-resolution CT (HRCT) is the modality of choice to detect and evaluate these calcifications (2). Cases We present one case of metastatic pulmonary calcification and five cases of dystrophic pulmonary calcification. Metastatic pulmonary calcification Metastatic pulmonary calcification (MPC) occurs in disease states...

Conclusion

We presented in short the most common causes of diffuse pulmonary calcification. This pattern can result from a variety of different conditions. These conditions all have a different presentation. A diagnostic approach is based on the patient's history and associated intrathoracic findings. A better understanding of these can lead to a more confident and specific diagnosis without the need for a open lung biopsy.

Personal information

References

1. Brown K, Mund DF, Aberle DR, Batra P, Young DA. Intrathoracic calcifications: radiographic features and differential diagnoses. RadioGraphics 1994; 14:1247-1261. 2. Edward D. Chan,Donald V. Morales,Carolyn H. Welsh,Michael T. McDermott, andMarvin I. Schwarz"Calcium Deposition with or without Bone Formation in the Lung",American Journal of Respiratory and Critical Care Medicine, Vol.165, No.12(2002), pp. 1654-1669. 3. Lara JF, Catroppo JF, Kim DU, et al. Dendriform Pulmonary Ossification, a Form of Diffuse Pulmonary Ossification: Report of a 26Year Autopsy Experience. Arch Pathol Lab Med 129:348–353, 2005. 4....