The ultimate guide for chest calcifications: a review

Congress:

ECR 2020

Poster Number:

C-13593

Type:

Educational Exhibit

Keywords:

Chest, Cardiovascular system, Lung, Thorax, CT, Digital radiography, Diagnostic procedure, Calcifications / Calculi, Not applicable

Authors:

J. Carvalho¹, J. Sousa¹, C. Fernandes¹, M. França²; ¹Porto/PT, ²Maia/PT

DOI:

10.26044/ecr2020/C-13593

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-13593

Fig. 3: Non contrast CT showing a right upper lung nodule with stippled calcifications...

Fig. 6: Biopsy proven lung hamartoma adjacent to the descending aorta, showing central...

Fig. 4: Left hilar diffusely calcified lung metastasis from osteosarcoma (red circle).

Fig. 5: Partially calcified soft tissue mass (red circle) on the right lower lobe,...

Learning objectives

To review the spectrum of disorders associatedd with thoracic calcifications; To show how characteristics of calcifications may help to differentiate between different disorders.

Background

Thoracic calcifications are a common finding in routine chest radiographs and CTs. Etiologically, calcification can be divided into metastatic or dystrophic. While the former occurs in healthy tissues due to increased concentration of calcium and phosphate, the later occurs in damaged tissues under normal calcium and phosphate concentrations [1]. For the differential diagnosis, we should consider: •Clinical history •Location of calcification •Pattern of calcification •Associated findings

Findings and procedure details

According to their location, chest calcifications can be divided as: Lung parenchyma: Focal calcifications within lung nodulesare most frequently secondary to previous granulomatous disease. Granuloma calcification occurs after healing of the primary infection. When associated with ipsilateral mediastinal lymph node calcification, it is called “Ranke complex” (Fig. 2). Although traditionally described in tuberculosis infection, it is nonspecific and it can be secondary to other granulomatous infections. The pattern of calcification on a solitary pulmonary nodule is an important sign to ascertain benignity. While diffuse, central,...

Conclusion

Pulmonary classification is a common finding on chest imaging. Knowing the various etiologiesand radiological differences may help in the differential diagnosis and eliminatethe need for unnecessary invasive procedures.

Personal information and conflict of interest

J. G. Carvalho; Porto/PT - nothing to disclose M. M. França; Maia/PT - nothing to disclose J. Sousa; Porto/PT - nothing to disclose C. Fernandes; Porto/PT - nothing to disclose

References

1.Karwowski, W., Naumnik, B., Szczepański, M. and Myśliwiec, M. (2012). The mechanism of vascular calcification – a systematic review.Medical Science Monitor, 18(1), pp.RA1-RA11. 2.Mohsen, A. and McKendrick, M. (2003). Varicella pneumonia in adults.European Respiratory Journal, 21(5), pp.886-891. 3.Müller, N. and Silva, C. (2008).Imaging of the chest. Philadelphia: Saunders/Elsevier. 4.Aluja Jaramillo, F., Gutierrez, F., Díaz Telli, F., Yevenes Aravena, S., Javidan-Nejad, C. and Bhalla, S. (2018). Approach to Pulmonary Hypertension: From CT to Clinical Diagnosis.RadioGraphics, 38(2), pp.357-373. 5.Ling, L., Oh, J., Breen, J., Schaff, H., Danielson,...