CTICasesMetastatic Pulmonary Calcification
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Imaging findings
Serial chest CT scans show rapidly progressive bilateral lung findings in a patient with chronic renal failure. Initial CT shows ill-defined, amorphous, nodular opacities surrounding the bronchovascular bundles, with some subtle high-density areas. Within two months, these nodules evolve into more confluent, hazy ground-glass opacities. Within six months, the opacities progress to extensive, dense, and irregular consolidations representing metastatic pulmonary calcification. A bone scan reveals diffuse, intense radiotracer uptake throughout both lung fields.
Key takeaways
Metastatic pulmonary calcification is a metabolic deposition disorder associated with chronic renal failure and secondary hyperparathyroidism. The imaging findings can be highly dynamic, presenting initially as non-specific, amorphous, or vessel-centered ground-glass nodules that can mimic infection, edema, or hemorrhage. High-resolution CT shows a predilection for the upper lobes, and bone scintigraphy is diagnostic, demonstrating symmetric, intense pulmonary uptake of radiotracer.
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