CTICasesDendriform Pulmonary Ossification after COVID-19
Imaging findings
A patient with a normal chest one year earlier developed, after COVID-19, progressive reticulation and dense opacity confined largely to the right lung on serial radiographs. CT shows mild fibrosis with punctate, dense calcific or ossific material within areas of fibrosis on bone windows, together with subtle bilateral ground-glass opacity resembling residual organizing pneumonia. The patient has chronic kidney disease (CKD stage 3).
Key takeaways
Dendriform pulmonary ossification can develop relatively rapidly, within months, in areas of prior lung injury such as resolving pneumonia, aspiration, or post-COVID subacute injury, appearing as punctate branching ossification within fibrosis. In the setting of chronic kidney disease, accelerated dystrophic calcification from an abnormal calcium-phosphate product may also contribute, though the punctate branching pattern here favored dendriform ossification. It can be focal, confined to the previously involved region of lung.
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