19 Pulmonary Parenchymal Calcification

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig C 19-1 Histoplasmoma. Central calcification (arrow) in a solitary pulmonary nodule.

• Fig C 19-2 Histoplasmosis. Diffuse calcifications in the lungs produce a snowball pattern.

• Fig C 19-3 Tuberculosis. Bilateral fibrocalcific changes at the apices. There is upward retraction of the hila.

• Fig C 19-4 Plasma cell granuloma. CT scan shows amorphous calcification in a large solitary mass in the lingula.36

• Fig C 19-5 Healed chickenpox pneumonia. Multiple tiny calcific shadows are scattered widely and uniformly throughout both lungs. This 42-year-old asymptomatic man had had florid chickenpox with acute pneumonia 15 years earlier.7

• Fig C 19-6 Calcified mucoid impaction in bronchial atresia. (Courtesy of I. Ettman, MD.)36

• Fig C 19-7 Hamartoma. Pathognomonic popcorn-ball calcification in a solitary pulmonary nodule.

• Fig C 19-8 Silicosis. Tomogram of the chest demonstrates characteristic eggshell lymph node calcification associated with bilateral perihilar masses.

• Fig C 19-9 Metastases from osteosarcoma.

• Fig C 19-10 Bronchogenic carcinoma. (A) Plain chest radiograph shows a large mass in the right upper lobe extending into the middle lobe. A second large lesion is evident in the azygoesophageal recess. (B) CT scan demonstrates dystrophic central calcification within the lesion and scattered calcifications in the mediastinal mass.36

• Fig C 19-11 Leiomyosarcoma. (A) Plain chest radiograph in a woman with a history of thymic irradiation in infancy and pleural decortication for pneumothorax shows a large right lung mass that extends to the chest wall and contains dense eccentric calcification (curved arrows). Note the rib destruction (straight arrow). (B) CT scan more clearly shows peripheral dense foci of eccentric calcification (arrows) within the mass. (Courtesy of Stephanie Flicker, MD.)36

Fig C 19-12 Secondary hyperparathyroidism. Heterotopic calcification in a patient with chronic renal failure.

• Fig C 19-13 Broncholithiasis. Innumerable calcified masses scattered throughout the lungs.

• Fig C 19-14 Amyloidosis. Dystrophic calcification in nodular deposits in the lung.36