Metastatic pulmonary calcification with ossification in a child with acute lymphoblastic leukemia

Cohen, Marta C.; Drut, Ricardo

doi:10.1002/(sici)1099-0496(199902)27:2<134::aid-ppul11>3.0.co;2-n

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Metastatic pulmonary calcification is further subdivided into benign (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and malignant causes (16)(17)(18)(19)(20)(21) (Table 1). By far the most common cause of metastatic calcification is seen in patients on hemodialysis for chronic renal insufficiency.…”

Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

326

370

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Pulmonary calcification and ossification occurs with a number of systemic and pulmonary conditions. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Pathophysiologic states predisposing to pulmonary calcification and ossification include hypercalcemia, a local alkaline environment, and previous lung injury. Factors such as enhanced alkaline phosphatase activity, active angiogenesis, and mitogenic effects of growth factors may also contribute. The clinical classification of pulmonary calcification includes both metastatic calcification, in which calcium deposits in previously normal lung or dystrophic calcification, which occurs in previously injured lung. Pulmonary ossification can be idiopathic or can result from a variety of underlying pulmonary, cardiac, or extracardiopulmonary disorders. The diagnosis of pulmonary calcification and ossification requires various imaging techniques, including chest radiography, computed tomographic scanning, and bone scintigraphy. Interpretation of the presence of and the specific pattern of calcification or ossification may obviate the need for invasive biopsy. In this review, specific conditions causing pulmonary calcification or ossification that may impact diagnostic and treatment decisions are highlighted. These include metastatic calcification caused by chronic renal failure and orthotopic liver transplantation, dystrophic calcification caused by granulomatous disorders, DNA viruses, parasitic infections, pulmonary amyloidosis, vascular calcification, the idiopathic disorder pulmonary alveolar microlithiasis, and various forms of pulmonary ossification.

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Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

326

370

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“…The underlying mechanism of hypercalcemia in lymphoproliferative disorders has been identified as increased osteoclastic activity mediated by cytokines produced by the malignant cells, as parathormone-related protein, tumor necrosis factor, and interleukins 1 and 6 [10,11]. Another factor responsible of hypercalcemia can be decreased renal excretion of calcium due to decreased glomerular filtration and increased renal tubular absorption of calcium.…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Lymphoblastic Leukemia Presenting as Sever Hypercalcemia

Buonuomo

Ruggiero

Piastra

et al. 2004

Pediatric Hematology and Oncology

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A 9-year-old girl presented at the Pediatric Emergency Department with an acute onset of gastrointestinal symptoms due to hypercalcemia. Despite the absence of circulating blast, bone marrow biopsy was diagnostic of acute lymphoblastic leukemia. The hypercalcemia was initially treated with intravenous hydration and furosemide, and later on with bisphosphonates. However, the serum calcium levels normalized only after the beginning of specific chemotherapy. Hypercalcemia represents an emergency in children, and acute leukemia must be considered in its differential diagnosis, even when there are no circulating blasts.

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“…Among malignant etiologies, multiple myeloma is the most common cause of cancer-related hypercalcemia, which is seen in 20-30% of cases [ 5 , 6 ]. Rarely, MPC occurs in patients with leukemia [ 7 , 8 ]. Other malignant causes include parathyroid carcinoma [ 5 , 9 ], lymphoma, breast carcinoma, choriocarcinoma, malignant melanoma, synovial carcinoma, and hypopharyngeal squamous cell carcinoma [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Metastatic pulmonary calcification as a rare complication of end-stage renal disease with coexistence of pulmonary metastases from renal cell carcinoma: case report and literature review

et al. 2018

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PurposeWe present a case of metastatic pulmonary calcification (MCP) in an asymptomatic patient with chronic kidney disease after renal transplantation and nephrectomy due to renal cancer. Chest computed tomography (CT) revealed bilateral, diffuse, centrilobular ground-glass opacities and heterogeneous, high-density areas distributed throughout the lungs, predominantly in the upper and middle lobes. Unusually, in our patient the metastatic calcification coexisted with pulmonary metastases from renal cell carcinoma associated with end-stage renal disease. To our knowledge, such coexistence has not been previously described.Case reportCT, particularly high-resolution chest computed tomography (HRCT), plays an important role in detection and follow-up of MPC findings, which include ground-glass opacities and partially calcified nodules or consolidations, predominantly in the upper lung zones. Correct diagnosis is important because misdiagnosis may lead to improper or unnecessary treatment and/or procedures.ConclusionsMPC is a rare condition that results from calcium deposition in the normal pulmonary parenchyma. MPC commonly occurs in patients with end-stage chronic kidney disease due to abnormalities in calcium and phosphate metabolism. It is worth pointing out that despite the fact that the condition is called metastatic, it is a relatively benign lung disease with a generally good long-term prognosis.

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Metastatic pulmonary calcification with ossification in a child with acute lymphoblastic leukemia

Cited by 10 publications

References 11 publications

Calcium Deposition with or without Bone Formation in the Lung

Calcium Deposition with or without Bone Formation in the Lung

A Case of Acute Lymphoblastic Leukemia Presenting as Sever Hypercalcemia

Metastatic pulmonary calcification as a rare complication of end-stage renal disease with coexistence of pulmonary metastases from renal cell carcinoma: case report and literature review

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