Metastatic/Dendriform Calcification
Key Facts
Terminology
Nonneoplastic condition characterized by the deposition of calcified material in the lung parenchyma
Etiology/Pathogenesis
This condition may appear in response to different clinical conditions that may include
Epithelial malignancies
Lymphoproliferative disorders
Post-transplant
Renal failure
Pathophysiology
Exact mechanism to account for the occurrence of metastatic calcification is not known
Serum levels of calcium and phosphates may play a role
Clinical Issues
Prognosis
Depends on the underlying condition
Depends on the extent of the process in the lung
Microscopic Pathology
Calcified material may follow some specific pattern of involvement of the lung parenchyma
Interstitium
Around the bronchial wall
Around the airway
Usually follows the alveolar outlines
Diagnostic Checklist
Pattern of distribution
Clinical history of an associated condition
 Low-power view of a section of lung shows extensive presence of calcified material  in a haphazard pattern. The calcific material is deposited within the lung interstitium. |
 High-power view of the presence of calcific material  admixed with minimal inflammation  and focal fibroblastic component. Note the absence of cellular atypia. |
TERMINOLOGY
Synonyms
Metastatic calcification, dendritic calcification
Definitions
Nonneoplastic condition characterized by deposition of calcified material in the lung parenchyma
ETIOLOGY/PATHOGENESIS
Etiology
This condition may appear in response to different clinical conditions that may include
Epithelial malignancies
Lymphoproliferative disorders
Post-transplant
Renal failure
Pathophysiology
Exact mechanism to account for the occurrence of this disorder is not known
Serum level of calcium and phosphates may play a role in its development
CLINICAL ISSUES
Epidemiology
Incidence
Difficult to estimate since the disorder is secondary to different clinical conditions
Age
Can occur in any age group
Gender
No gender predilection
Ethnicity
No ethnic predilection
Site
Lung parenchyma
Laboratory Tests
Serum levels of calcium and phosphates may be altered
Natural History
Develops as a secondary process from diverse clinical conditions
Process may not be limited to the pulmonary system
Treatment
Surgical approaches
Patients usually require surgical resection of the portion of the lung affected
Prognosis
Depends on the underlying condition
From the strict point of view of calcified deposits in the lung parenchyma, prognosis depends on the extent of the process
IMAGE FINDINGS
General Features
Bilateral
Dense
Asymmetrical
Other Studies
Dual-energy digital radiography appears to be more sensitive modality
MACROSCOPIC FEATURES
General Features
Lung parenchyma appears congested and gritty
Cut surface may be hard in consistency
MICROSCOPIC PATHOLOGY
Histologic Features
Haphazard distribution of calcified material in the lung parenchyma
Calcified material may follow some specific pattern of involvement of the lung parenchyma
Interstitial deposition
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
