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BIBTEX RIS

Metastatic pulmonary calcification: State-of-the-art review focused on imaging findings

2014; Elsevier BV; Volume: 108; Issue: 5 Linguagem: Inglês

10.1016/j.rmed.2014.01.012

1532-3064

Luciana Camara Belém, Gláucia Zanetti, Arthur Soares Souza, Bruno Hochhegger, Marcos Duarte Guimarães, Luiz Felipe Nobre, Rosana Souza Rodrigues, Edson Marchiori,

Bone health and treatments

Metastatic pulmonary calcification (MPC) is a subdiagnosed metabolic lung disease that is commonly associated with end-stage renal disease. This interstitial process is characterized by the deposition of calcium salts predominantly in the alveolar epithelial basement membranes. MPC is seen at autopsy in 60–75% of patients with renal failure. It is often asymptomatic, but can potentially progress to respiratory failure. Chest radiographs are frequently normal or demonstrate confluent or patchy airspace opacities. Three patterns visible on high-resolution computed tomography have been described: multiple diffuse calcified nodules, diffuse or patchy areas of ground-glass opacity or consolidation, and confluent high-attenuation parenchymal consolidation. The relative stability of these pulmonary infiltrates, in contrast to infectious processes, and their resistance to treatment, in the clinical context of hypercalcemia, are of diagnostic value. Scintigraphy with bone-seeking radionuclides may demonstrate increased radioactive isotope uptake. The resolution of pulmonary calcification in chronic renal failure may occur after parathyroidectomy, renal transplantation, or dialysis. Thus, the early diagnosis of MPC is beneficial. The aim of this review is to describe the main clinical, pathological, and imaging aspects of MPC.