Diffuse Pulmonary Ossification Developing in Patients with End-stage Renal Disease

Abstract

Diffuse pulmonary ossification (DPO) is a rare condition characterized by chronic metaplastic ossification of the lung parenchyma. DPO is associated with various underlying pulmonary, cardiac, and systemic diseases. However, to our knowledge, DPO has rarely been described in patients with end-stage renal disease undergoing hemodialysis. We describe two cases of DPO diagnosed in long-term hemodialysis patients. Awareness of this rare disorder is required for a better differential diagnosis of cases presenting with bilateral diffuse micronodular lesions, including calcific opacities. (Korean J Med 2016;90:346-350)

Needles in the Lungs: An Autopsy Case of Pulmonary Ossification in a Putrefied Body

“…It is assumed that this condition contributes to the calcification and ossification observed in the pulmonary parenchyma. Similarly, two cases of diffuse pulmonary ossification in patients with end-stage renal disease were reported in a previous study [6].…”

“…Nodular pulmonary ossification occurs pathologically within the intra-alveolar space and is considered a consequence of alveolar exudate due to secondary congestion [5]. Dendriform ossification, also known as dendriform pulmonary ossification, is idiopathic or associated with various underlying pulmonary and systemic disorders [6]. Pathological findings of dendriform pulmonary ossification were defined as interstitial branching spicules of the bone and marrow elements [3].…”

Proceedings of the 2022 National Toxicology Program Satellite Symposium

“…Dendriform pulmonary ossification can be idiopathic or associated with several conditions, including usual interstitial pneumonia, chronic obstructive pulmonary disease, pneumoconiosis, chronic gastroesophageal reflux disease, end-stage renal disease, and genetic mutations. [55][56][57][58][59][60]63,65 DPO has been reported in coyotes with pneumoconiosis, a dog with multiple mammary tumors, and a dog treated with exogenous cortisol. 61,62,64 An overt cause of pulmonary ossification was not identified in this case.…”

“…DPO is typically diagnosed as an incidental finding on postmortem examination, although pneumothorax may occur due to pleural rupture. [55][56][57][58][59][60][61][62][63][64][65] Two histologic subtypes of DPO are described in humans: nodular and dendriform.…”