Diffuse pulmonary ossification: an unusual interstitial lung disease

Peroš-Golubičić, Tatjana; Tekavec-Trkanjec, Jasna

doi:10.1097/mcp.0b013e3283043e1b

Cited by 46 publications

(45 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Saks et al reported a case of DPO detected using bone scanning with Tc-99m hydroxymethylene in 1984 (8). However, it has also been reported that Tc-99m hydroxymethylene is less sensitive in the nonextensive stage (2). In this case, the laboratory findings showed slight elevations of urinary deoxypyridinoline and serum I-CTP, which usually imply the predominance of bone resorption.…”

Section: Discussionmentioning

confidence: 74%

See 1 more Smart Citation

A Rare Case of Asymptomatic Diffuse Pulmonary Ossification Detected during a Routine Health Examination

et al. 2012

View full text Add to dashboard Cite

A 26-year-old man presented at our hospital in 2008 to undergo detailed investigations as part of a routine health examination. Chest computed tomography (CT) showed linear and reticular opacities with, in part, diffuse calcification in the lung fields bilaterally. A surgical lung biopsy was performed and the histological findings were compatible with a diagnosis of diffuse pulmonary ossification (DPO) of the dendriform type. DPO usually occurs as a secondary disease. As the histological changes in interstitial fibrosis were minimal rather than diffuse and not significant enough to be regarded as interstitial pneumonia, we considered this to be an idiopathic case. However, the findings appear to suggest that inflammation and fibrosis were associated with ossification.

show abstract

Section: Discussionmentioning

confidence: 74%

“…DPO is usually associated with cardiovascular or respiratory disease. Therefore, the number of idiopathic cases is very small (1)(2)(3)(4). We herein present an idiopathic case of DPO detected during a routine health examination.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Asymptomatic Diffuse Pulmonary Ossification Detected during a Routine Health Examination

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Nodular pulmonary ossification has been associated with chronically elevated central venous pressure and is thought to be due to hemosiderin deposition within the alveoli due to chronic vascular congestion. 5,6 Dendriform pulmonary ossification has been most associated with pulmonary fibrosis [7][8][9] and is thought to result from recurrent lung injury with resulting calcium deposition due to inflammatory cytokines and an alkaline environment. 5 Tissue sampling with pathologic evaluation provides the definitive means for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…5,10 Few studies have been devoted to the treatment of this disorder. Low calcium diet, calcium-binding drugs, and corticosteroids, all failed to show effectiveness for decreasing calcium deposition within the lungs because of various underlying conditions.…”

Section: Discussionmentioning

confidence: 99%

The Imaging Evaluation of Pulmonary Ossification

Tomich

Gyurjyan

Shaves

2013

Clinical Pulmonary Medicine

View full text Add to dashboard Cite

Diffuse pulmonary ossification is a rare condition characterized by heterotopic bone formation within the lung parenchyma. Diagnosis is ultimately made by histology, which demonstrates islands of ossification within the connective tissues or alveoli of the lungs. The disease remains underrecognized clinically, with most reported cases identified by autopsy series. However, with the advent of high-resolution computed tomography, our ability to identify these patients early has improved. High-resolution computed tomography is able to identify smaller foci of pulmonary ossification with greater specificity than standard computed tomography imaging. In this article, we use an example case to illustrate the classic imaging features of pulmonary ossification, which presents as high-density (400 to 500 HU) ossification of the alveoli or connective tissues with lower lobe predominance. Two main patterns of ossification have been described: nodular and dendriform. Both patterns can coexist in the same patient; however, the predominant pattern may suggest the underlying etiology. The nodular pattern is most commonly associated with chronically elevated central venous pressure, whereas the dendriform pattern is associated with chronic inflammation. Increased recognition and early diagnosis of this condition may lead to improved treatment strategies for these patients in the future.

show abstract

“…1,5 Other influences, such as angiogenesis, chronic venous congestion, and abnormal mineral metabolism, may play a role as well. 1,5,6 There are two types of ossification, localized and diffuse. The localized type refers to focal deposition of bone within or adjacent to lung tissue injured by any kind of disease process, mainly including lung abscess, tuberculosis and other infectious, or parasitic diseases, trauma, primary tumors, and metastatic cancer.…”

Section: Authors' Commentmentioning

confidence: 99%

Selected Case From the Arkadi M. Rywlin International Pathology Slide Series

Bisceglia¹,

Chiaramonte

Panniello

et al. 2015

Advances in Anatomic Pathology

View full text Add to dashboard Cite

Two cases of diffuse dendriform pulmonary ossification (DPO) are presented, one of the secondary type and the other of the idiopathic type. Case 1 was an adult female patient who underwent thoracic surgery to remove a posterior mediastinal bronchogenic cyst, which was discovered on a computed tomography scan performed after an episode of pneumonia when traction bronchiectasis with interstitial lung disease/fibrosis was also suspected in the lungs. Histologic examination performed on the resected lung tissue revealed numerous scattered small osseous spicules on a background of intense interstitial inflammation and fibrosis, leading to further clinical and laboratory investigations and the final diagnosis of DPO secondary to lung involvement by scleroderma. Case 2 was an adult male patient who underwent thoracoscopic exploration after a computed tomography scan, which revealed traction bronchiectasis with linear thickening of the interstitial lung tissue. Histologic examination of the lung tissue specimen revealed numerous osseous spicules in the absence of interstitial septal inflammation. Noteworthy in this case were also some nodules of collagenized tissue similar to those seen in the lungs of patients affected by Ehlers-Danlos syndrome. The absence of any clinical sign or symptoms related to Ehlers-Danlos syndrome attest to the nonspecificity of these pulmonary fibrous nodules. No case of DPO secondary to scleroderma has been reported in the literature so far, although around half of the patients with scleroderma manifest pulmonary diseases. Idiopathic DPO is even rarer, usually discovered postmortem, with only 20 cases diagnosed in life with lung biopsies taken by open surgery or through a thoracoscopic approach. DPO is often misdiagnosed radiologically as bronchiectasis and/or interstitial lung disease/fibrosis.

show abstract

Diffuse pulmonary ossification: an unusual interstitial lung disease

Cited by 46 publications

References 16 publications

A Rare Case of Asymptomatic Diffuse Pulmonary Ossification Detected during a Routine Health Examination

A Rare Case of Asymptomatic Diffuse Pulmonary Ossification Detected during a Routine Health Examination

The Imaging Evaluation of Pulmonary Ossification

Selected Case From the Arkadi M. Rywlin International Pathology Slide Series

Contact Info

Product

Resources

About