noduläre pulmonale Ossifikation
noduläre pulmonale Ossifikation
pulmonale Ossifikation Radiopaedia • CC-by-nc-sa 3.0 • de
Pulmonary ossification is a rare finding and is characterized by the presence of mature bone in alveolar or interstitial spaces, either localized or disseminated throughout the lung parenchyma.
It can be idiopathic (idiopathic pulmonary ossification) or secondary to chronic lung, cardiac or systemic disorders.
Terminology
At times radiologists will report this as "pulmonary calcification", but it is important to realize that this is incorrect as the abnormality is formed from bone cells.
Pathology
It is thought to be a result of multiple interacting factors. Tissue injury is considered the most important provoking factor which, in an alkaline environment, initiates calcium salt precipitation, enables alkaline phosphatase activity and activates profibrogenic cytokines. Alveolar hemorrhage is responsible for an interstitial metallic deposition that attracts calcium salts and multinucleated giant cells.
Morphological subtypes
Associations
- fibrosing lung diseases:
- usual interstitial pneumonia: disseminated form
- pulmonary amyloidosis: especially nodular form
- mitral valve stenosis: late sign associated with pulmonary hypertension - prevalence of 3-13%
Radiographic features
Plain radiograph
May show branching calcific densities, which are usually seen in lower parts of lungs.
CT
High attenuation parenchymal bands.