Belém Luciana Camara, Souza Carolina A, Souza Arthur Soares, Escuissato Dante Luiz, Hochhegger Bruno, Nobre Luiz Felipe, Rodrigues Rosana Souza, Gomes Antônio Carlos Portugal, Silva Claudio S, Guimarães Marcos Duarte, Zanetti Gláucia, Marchiori Edson
MD, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
MD, PhD, Ottawa Hospital Research Institute, University of Ottawa, Canada.
Radiol Bras. 2017 Jul-Aug;50(4):231-236. doi: 10.1590/0100-3984.2016-0123.
The aim of this study was to evaluate the high-resolution computed tomography (HRCT) findings in patients diagnosed with metastatic pulmonary calcification (MPC).
We retrospectively reviewed the HRCT findings from 23 cases of MPC [14 men, 9 women; mean age, 54.3 (range, 26-89) years]. The patients were examined between 2000 and 2014 in nine tertiary hospitals in Brazil, Chile, and Canada. Diagnoses were established by histopathologic study in 18 patients and clinical-radiological correlation in 5 patients. Two chest radiologists analyzed the images and reached decisions by consensus.
The predominant HRCT findings were centrilobular ground-glass nodules ( = 14; 60.9%), consolidation with high attenuation ( = 10; 43.5%), small dense nodules ( = 9; 39.1%), peripheral reticular opacities associated with small calcified nodules ( = 5; 21.7%), and ground-glass opacities without centrilobular ground-glass nodular opacity ( = 5; 21.7%). Vascular calcification within the chest wall was found in four cases and pleural effusion was observed in five cases. The abnormalities were bilateral in 21 cases.
MPC manifested with three main patterns on HRCT, most commonly centrilobular ground-glass nodules, often containing calcifications, followed by dense consolidation and small solid nodules, most of which were calcified. We also described another pattern of peripheral reticular opacities associated with small calcified nodules. These findings should suggest the diagnosis of MPC in the setting of hypercalcemia.
本研究旨在评估经诊断为转移性肺钙化（MPC）患者的高分辨率计算机断层扫描（HRCT）表现。
我们回顾性分析了23例MPC患者的HRCT表现[男性14例，女性9例；平均年龄54.3岁（范围26 - 89岁）]。这些患者于2000年至2014年期间在巴西、智利和加拿大的9家三级医院接受检查。18例患者通过组织病理学研究确诊，5例患者通过临床 - 放射学相关性确诊。两名胸部放射科医生分析图像并通过共识做出诊断。
HRCT的主要表现为小叶中心性磨玻璃结节（n = 14；60.9%）、高密度实变（n = 10；43.5%）、小致密结节（n = 9；39.1%）、伴有小钙化结节的外周网状影（n = 5；21.7%）以及无小叶中心性磨玻璃结节的磨玻璃影（n = 5；21.7%）。4例患者发现胸壁血管钙化，5例患者观察到胸腔积液。21例患者的异常表现为双侧性。
MPC在HRCT上表现为三种主要模式，最常见的是小叶中心性磨玻璃结节，通常含有钙化，其次是致密实变和小实性结节，其中大部分为钙化。我们还描述了另一种伴有小钙化结节的外周网状影模式。在高钙血症背景下，这些表现应提示MPC的诊断。
