Histologically Proven Dendriform Pulmonary Ossification: A Five-case Series

Abstract

Dendriform pulmonary ossification (DPO) is a rare condition characterized by metaplastic bone formation in the lung parenchyma. It has been reported to be often associated with primary lung diseases, such as usual interstitial pneumonia (UIP) or chronic aspiration of gastric acid; however, its clinical features and pathophysiology remain unclear, especially in idiopathic cases. We herein report five DPO cases, including three with an idiopathic origin. In all cases of idiopathic DPO, the pathological and radiological examinations showed localized pulmonary lesions suggesting inflammation or hemorrhaging.

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

“…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]. Pathological examination revealed branching bone spicules containing marrow tissue in this case, as well as lesions in both lower lobes of the lungs.…”

“…PM computed tomography (CT) was performed, but no pulmonary ossification was observed. Pulmonary ossification is not always visible on CT because of its microscopic size [3]. Microscopic examination revealed pulmonary ossification, accompanied by calcification.…”

“…The lesion was not visible on chest radiography. Several recent cases of diffuse pulmonary ossification have been diagnosed due to radiologic developments; however, this condition often remains under-or misdiagnosed [3]. Pulmonary ossification can also be incidentally identified during autopsy.…”

Dendriform Pulmonary Ossification: Findings from Eight Years of Observation

“…Very few reports of long-term observation of DPO have been reported; thus, information on the prognosis is limited. Some case reports have described asymptomatic patients with normal pulmonary function test results for 9 and 12 years ( 2 , 3 ). However, two other patients had dyspnea on exertion.…”

“…As the disease usually occurs without symptoms, most cases are diagnosed at an autopsy. The clinical course is thus uncertain, and cases with long-term observation have rarely been reported (2)(3)(4)(5).…”