Endogenous Mineralization, Inclusions, and Deposition Disorders

Farver, Carol; Dail, David H.

doi:10.1007/978-0-387-68792-6_21

Cited by 5 publications

(11 citation statements)

References 237 publications

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“…[1][2][3][4] The pathogenetic mechanisms of ossification have not been fully elucidated. However, tissue injury seems to be an important initial factor.…”

Section: Authors' Commentmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17] The diffuse type refers to the disseminated formation of spicules or nodules of bone in the interalveolar, interlobular, and subpleural connective tissue of the entire lung and in the alveolar spaces. [2][3][4][5]18,19 Two types of diffuse pulmonary ossification are recognized: the nodular, circumscribed, or tuberous type, and the dendriform, branching, racemose, or trabecular type. The nodular type is usually seen in association with heart diseases, especially mitral valve stenosis and other conditions leading to venous pulmonary hypertension, such as chronic left ventricular failure and idiopathic hypertrophic subaortic stenosis, [2][3][4][5][18][19][20] and was more commonly observed in the past decades due to the poor management and prevention of rheumatic heart disease.…”

Section: Authors' Commentmentioning

confidence: 99%

“…[2][3][4][5]18,19 Two types of diffuse pulmonary ossification are recognized: the nodular, circumscribed, or tuberous type, and the dendriform, branching, racemose, or trabecular type. The nodular type is usually seen in association with heart diseases, especially mitral valve stenosis and other conditions leading to venous pulmonary hypertension, such as chronic left ventricular failure and idiopathic hypertrophic subaortic stenosis, [2][3][4][5][18][19][20] and was more commonly observed in the past decades due to the poor management and prevention of rheumatic heart disease. Approximately 90 cases of this nodular type of pulmonary ossification with pathologic confirmation have been reported so far 18,21-36 (our literature review started from the compilation of 1959 made by Wilson et al, 37 who found 23 cases reported in the world literature up to that time from its first description in 1859 by Wagner, 38 and added 4 new cases of their own).…”

Section: Authors' Commentmentioning

confidence: 99%

“…[1][2][3][4] The distinction between racemose and nodular might not always be so straightforward, and even the words may have different meanings to different individuals, with one person's "nodular" being another's "racemose." For example, a surgeon or radiologist might describe as nodular, ossification that is dendriform/racemose to the pathologist.…”

Section: Authors' Commentmentioning

confidence: 99%

“…63 With reference to both autopsy and biopsy-proven diagnoses of DPO, in three cases there was a clinical history of occupational exposure to asbestos 40(case 7), 65(case 2), 66(case 2) , other heavy metals, such as aluminum 69,85(case 1) , or rare earth metals (cerium and lanthanum). 98 Aluminum and iron deposits were also demonstrated in the pulmonary bony tissue of another 2 patients without work exposure 84(cases [2][3] . In 3 cases hydrocarbon combustion products were suspected to be cofactors in DPO pathogenesis.…”

Section: Authors' Commentmentioning

confidence: 99%

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

Bisceglia¹,

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et al. 2015

Advances in Anatomic Pathology

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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.

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“…[1][2][3][4] The pathogenetic mechanisms of ossification have not been fully elucidated. However, tissue injury seems to be an important initial factor.…”

Section: Authors' Commentmentioning

confidence: 99%