Loh Thian Chee, Pang Yong Kek, Liam Chong Kin, Chew Man Fong, Tan Jiunn Liang
Department of Medicine, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia.
Department of Pathology, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia.
Respirol Case Rep. 2022 Sep 1;10(10):e01030. doi: 10.1002/rcr2.1030. eCollection 2022 Oct.
Metastatic pulmonary calcification (MPC) is characterized by deposition of calcium in the normal lung parenchyma secondary to elevation of serum calcium. Most patients are asymptomatic and routine chest radiograph is not sensitive to make the diagnosis. Further imaging is needed such as computed tomography (CT) which typically shows small centrilobular nodules in the upper lobes. We report a case of a 30-year-old woman with end stage kidney disease who was diagnosed with pulmonary tuberculosis which was then revised to metastatic pulmonary calcification. The CT thorax feature for this patient was atypical for metastatic pulmonary calcification where it demonstrated tree-in-bud nodules suggestive of infection. The final diagnosis was made based on bronchoalveolar lavage which was culture-negative for and transbronchial lung biopsy demonstrating calcium deposition in the interstitium.
转移性肺钙化(MPC)的特征是在血清钙升高继发的正常肺实质中钙沉积。大多数患者无症状,常规胸部X线片对诊断不敏感。需要进一步的影像学检查,如计算机断层扫描(CT),其通常显示上叶有小的小叶中心结节。我们报告一例30岁终末期肾病女性患者,最初诊断为肺结核,后来修正为转移性肺钙化。该患者胸部CT表现对于转移性肺钙化而言不典型,显示出提示感染的树芽状结节。最终诊断基于支气管肺泡灌洗(培养结果为阴性)和经支气管肺活检(显示间质中有钙沉积)。