CTICasesMigratory Calcified Pleural Bodies from Extrapleural Fat Necrosis
Imaging findings
CT of the basal hemithoraces shows two calcifications, each with a central dense focus surrounded by a rim of soft tissue of slightly low, possibly fatty, attenuation, giving an inverted-doughnut appearance. Comparison with a prior spine CT demonstrates that the calcified bodies have changed position within the pleural space over time, one on the right and one more laterally on the left.
Key takeaways
Migratory calcified pleural bodies are thought to arise from areas of fat necrosis in extrapleural fat that undergo dystrophic calcification, break off, and migrate into the pleural space, carrying a small amount of infarcted fat or dried proteinaceous pleural fluid with them. Recognizing the surrounding rim of tissue and the migratory behavior on serial imaging helps identify these benign structures rather than misinterpreting them. These were among the largest such calcified bodies the group had seen.
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