Idiopathic pulmonary ossification.

Abstract

Idiopathic pulmonary ossification is an uncommon and asymptomatic disorder of unknown etiology in which trabeculated bone is found in the lung. It is usually mistaken for more serious entities radiographically, most commonly appearing as branching linear shadows of calcific density involving a limited area of the lung and exhibiting very slow progression; however, the shadows may be round or irregular and bulky. Sometimes the trabeculae are recognizable, and occasionally the lungs demonstrate widespread involvement. The authors describe 8 proven cases, including one in which a bone scan revealed uptake by heterotopic bone in the lung.

Ossificação pulmonar dendriforme

“…(6) Serum levels of calcium, phosphate, and alkaline phosphatase are normal.There is no evidence of parathyroid diseases or other conditions causing metastatic calcinosis. (4) Pulmonary function test results show a restrictive pattern, with a decrease in the diffusing capacity.The definite diagnosis is made through open lung biopsy. (6) Imaging results show reticular infiltrates of calcified density (dendriform type) throughout the bronchovascular distribution.…”

“…(9) The histopathological type described herein is the dendriform pulmonary ossification one, also known as: pulmonary osteopathy, idiopathic disseminated pulmonary ossification, ossifying pneumonitis, bone metaplasia of the lung, racemose or reticular osteoplastic pulmonary disease, and arboriform ossification. (4,10) Dendriform pulmonary ossification is found associated with several conditions, such as histoplasmosis, chronic therapy with busulfan, pulmonary metastases of osteogenic sarcoma, pulmonary amyloidosis, areas of dystrophic calcifications, (1,11) and Goodpasture's syndrome.…”

“…These infiltrates are commonly interpreted as scars, fibrosis, bronchiectasis, or multiple subpleural calcifications (nodular type) smaller than 1 cm, which are mistaken for scars resulting from infectious diseases. (4) Ossifications have been histologically described six months after the onset of the congestive symptoms, although the process might only be seen radiographically after three to five years. (2) The lesions are indolent, with slow progression over the years, and may remain unchanged for many years.…”

“…Therefore, most of the cases have been diagnosed at autopsy. (2)(3) Since it was first described by Luschka in 1856, (4)(5)(6)(7)(8) fewer than 100 cases have been reported.…”

Nodular pulmonary ossifications in differential diagnosis of solitary pulmonary nodules

“…DPOs represent the less common form and are associated with pulmonary inflammation, pulmonary fibrosis, chronic obstructive pulmonary disease, asbestosis and pneumonia or may be idiopathic [3]. In a total of 1,393 adult autopsy cases performed by LARA et al [1], only eight were identified as having dendritic calcifications, an average of 0.6% of all adult autopsies or one case every 3 yrs.…”