Metastatic Pulmonary Calcification Detected on 18F-FDG PET/CT and 99mTc-MDP Bone Scan

Metastatic calcification relates to abnormal calcification resulting from hypercalcemia and can affect soft tissues, skeletal muscle, myocardium, lungs, stomach, kidneys, and blood vessels. We describe a case of metastatic pulmonary calcification in a 71-year-old male, images with 18F-fluorodeoxyglucose (FDG) PET/CT and 99mTc- methylene diphosphonate (MDP) bone scan.

Metastatic Pulmonary Calcification in a Hemodialysis Patient after Renal Transplantation

This is the case of a 64-year-old man, on renal replacement therapy since 2008, due to autosomal dominant polycystic kidney disease. The patient was on peritoneal dialysis from 2008 to 2016, when he underwent renal transplantation. Transplant duration was less than a month due to acute vascular rejection. Since then, he is on hemodialysis. A few months after transplantation, it was incidentally identified confluent bilateral opacities, more prominent on the left lung in a routine X-ray (Figure 1). The patient had made a chest radiography in 2015 without any changes at that time. The CT scan showed parenchymatous densification areas, partially calcified, in both lungs (Figure 2). The patient also developed secondary hyperparathyroidism refractory to medical therapy but refused surgery. Nevertheless, the lesions had a slow progression until the present time.

Metastatische pulmonale calcificaties als zeldzame oorzaak van matglasopaciteiten op een CT-scan

Metastatic pulmonary calcification: a case report and literature overview Ground-glass opacities have a broad differential diagnosis, including infectious, metabolic, inflammatory and malignant causes. This case presents an underdiagnosed entity of dense ground-glass opacities, namely metastatic pulmonary calcifications (MPC). This is a benign metabolic disease characterised by the deposition of calcium in the lungs, mostly described in patients with chronic kidney injury and secondary hyperparathyroidism. The majority of the patients require no treatment, but in some cases it may lead to irreversible lung damage. Clinical and radiological features, as well as the patient’s history, are crucial to make a correct diagnosis since MPC has a relatively specific appearance on imaging. This case study discusses the medical history and imaging appearance of a 44-year-old woman with MPC, followed by a literature overview.

Rare Surgical Lung Biopsy Findings of Metastatic Pulmonary Calcification Associated with Chronic Renal Failure

Introduction/Objective Metastatic pulmonary calcification is a metabolic lung disease characterized by depositions of calcium in lung parenchyma. Depositions of calcium salts are usually caused by hypercalcemia and are associated with end-stage renal disease, primary and secondary hyperparathyroidism, and hemodialysis. It is mostly asymptomatic and clinically silent but can lead to life-threatening respiratory failure. Methods We present a case of a 53-year-old woman, with a failed renal transplant and on hemodialysis, admitted with cough and shortness of breath. Computed tomography showed extensive diffuse bilateral groundglass and nodular opacities. Bronchoscopy was unremarkable. BAL results were negative for infection. The initial differential diagnosis included pneumonitis, interstitial lung disease, and chronic obstructive pulmonary disease. VATS lung wedge resection was performed. Results Microscopically there were numerous interstitial, peribronchial and perivascular calcifications highlighted by Van Kossa stain. Calcifications were associated with a marked interstitial fibrosis confirmed by trichrome stain. There was no evidence of significant acute and chronic inflammation, granulomas, fibroblastic foci and vasculitis. Conclusion Metastatic pulmonary calcification is found in 60–80% of autopsies of patients undergoing dialysis treatment. It is rarely diagnosed during their lifetime, because patients are usually asymptomatic, or the imaging findings are negative. The diagnosis of metastatic pulmonary calcification in our patient prompt further evaluation for repeat kidney transplant and the patient is being considered for parathyroidectomy for her tertiary hyperparathyroidism.

Metastatic pulmonary calcification diagnosed by transbronchial cryobiopsy

Metastatic pulmonary calcification is a rare disease characterized by calcium deposits in the lung. We describe a case where this pathology is observed associated with bone lithic lesions and kidney failure and it was diagnosed with transbronchial cryobiopsy.