CTICasesCaseous Calcification of the Mitral Annulus (CCMA) with Pulmonary MAC Infection
Imaging findings
Chest CT demonstrates a well-circumscribed, hyperdense, mass-like calcified lesion with a central area of lower attenuation along the posterior mitral valve annulus, diagnostic of caseous calcification of the mitral annulus. Coexisting lung parenchyma findings include bronchiectasis and clustered tree-in-bud nodular opacities, typical of a chronic pulmonary Mycobacterium avium complex infection.
Key takeaways
Caseous calcification of the mitral annulus is a benign, non-neoplastic variant of mitral annular calcification characterized by a central liquefied caseous mixture of protein and calcium. On imaging, it can mimic a cardiac tumor, abscess, or thrombus, and should not be mistaken for active infection or malignancy. This case presents a humorous linguistic pairing of cardiac caseous calcification of the mitral annulus with pulmonary Mycobacterium avium complex infection.
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