CTICasesMetastatic Pulmonary Calcification Demonstrating a Rosette Pattern
Imaging findings
In a second patient with end-stage renal disease and a central catheter draining directly into the hepatic veins/IVC (due to absent SVC and IVC access), chest imaging shows more confluent calcification than the prior case, with a distinctive rosette pattern of calcified foci and upper-lobe predominance, visible even on the plain radiograph.
Key takeaways
Metastatic pulmonary calcification can occasionally be dense enough to produce a visible rosette pattern on both CT and plain radiography, and this pattern -- also described in calcified pulmonary hemorrhage -- again reflects the upper-lobe oxygen-tension and pH gradient that favors calcium precipitation in chronic renal failure.
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