Version June 2024
| Underlying processes | Symptoms | Chest radiograph | HRCT | Other testing | |
| Metastatic pulmonary calcification | ESKD on hemodialysis Orthotopic liver transplantation Malignancy with hypercalcemia Hyperparathyroidism Hypervitaminosis D | Often asymptomatic | May be normal or may have upper lung zone reticular opacities | Upper lung zone ground-glass nodular opacities with multiple small calcified nodules (diffuse or localized) Dense consolidation | Densitometry of thin-slice (1 mm) HRCT shows attenuation consistent with calcification 99mTc-MDP radiotracer: diffuse uptake in lungs |
| Dystrophic calcification | Granulomatous diseases (eg, fungal, mycobacterial, or viral infection, amyloidosis, sarcoidosis) | Symptoms, when present, are related to underlying disease process | Appearance varies with the underlying disease | Appearance varies with the underlying disease | Serum levels of calcium and phosphate are normal |
| Pulmonary alveolar microlithiasis | Autosomal recessive mutation of the SLC34A2 gene that encodes a type IIb sodium-dependent phosphate transporter | Progressive dyspnea after age 20 years, but variable age of onset | "Sandstorm" appearance with diffuse micronodules and predilection for the lung bases, often obscuring the contours of the heart and diaphragm | Micronodular calcifications primarily located along bronchovascular bundles, subpleural and perilobular regions Nodules are smaller than those of MPC | Lamellar microliths in BAL fluid Widespread deposition of calcium phosphate lamellar microliths throughout the lungs Genetic testing, although this has limited availability |
| Pulmonary ossification-nodular | Usually associated with underlying cardiac disorder and chronic venous congestion | Asymptomatic or symptoms due to underlying cardiac disease | Coarse reticular opacities in the lower lung zones | HRCT demonstrates nodular 1 to 5 mm calcific densities, typically in the lung periphery Measurement of lesion density confirms bone density | Densitometry of thin-slice (1 mm) HRCT: attenuation consistent with calcification Lamellar deposits of osteoid material in alveolar spaces on histopathology |
| Pulmonary ossification-dendriform | Idiopathic or associated with fibrotic lung disease | Asymptomatic or symptoms are related to underlying lung disease | HRCT demonstrates linear 1 to 5 mm calcific densities, typically in the lung periphery | HRCT densitometry: attenuation of calcified tissue Histopathology shows branching deposits of bone and marrow elements in the interstitium – may extend into alveolar spaces |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
