Idiopathic dendriform pulmonary ossification diagnosed by bronchoscopic lung cryobiopsy: A case report

Abstract

Dendriform pulmonary ossification (DPO) is a rare condition characterized by heterotopic bone production of unknown origin within the pulmonary tissue. Many cases are asymptomatic with slow progression and are often diagnosed incidentally during autopsy. Thus, only few cases are diagnosed while the patient is still alive since surgical lung biopsy is often needed for pathological diagnosis. This is the case of a 37-yearold man treated at our hospital due to abnormal findings on chest x-ray without any symptoms. His high-resolution computed tomography revealed diffuse reticular shadows and micronodules, consistent with calcification. He underwent transbronchial lung cryobiopsy (TBLC) and was diagnosed with idiopathic DPO based on pathological findings. To our knowledge, this is the first reported case of DPO diagnosed using TBLC. TBLC can be a useful yet minimally invasive diagnostic tool to diagnose DPO and other interstitial lung diseases.

Nationwide retrospective observational study of idiopathic dendriform pulmonary ossification: clinical features with a progressive phenotype

“…Other secondary cases of DPO were observed in patients in their 60s–80s 32 33. However, recent reports have shown that IDPO diagnosed by surgical lung biopsy was distributed among patients in their 20s–40s 16–18 25–29. In our study, the diagnosis was made in 5 patients in their 20s and 8 patients in their 30s.…”

“…9 In the 2000s, several cases of idiopathic cases of pulmonary ossification in the absence of underlying pulmonary or systemic diseases were reported. [10][11][12][13][14][15][16][17][18] The information from these reports indicates the homogenous clinical features such as male-predominance, asymptomatic disease and branching-type ossification on HRCT scans and/or histological findings, but, to our knowledge, there is no comprehensive study on the clinical features including onset, pulmonary function, complications, clinical course, biomarkers and prognosis, in addition to radiological and histopathological details.…”