Subcutaneous calcifications masquerading as pulmonary lesions in long-term hemodialysis. Review of nodular pulmonary opacities in the population undergoing hemodialysis.

Calcification of soft tissue frequently occurs in patients undergoing hemodialysis for chronic renal failure and involves the arteries, eyes, periarticular regions, lungs, heart, abdominal viscera, subcutaneous tissues, and skin. In this report, two such patients are described who presented with apparent pulmonary nodules on their chest roentgenograms obtained on admission. By the use of tomograms and apical lordotic views, both proved to have extrapulmonary calcific deposits in the subcutaneous tissues overlying the upper pulmonary zones. The tendency for these collections to undergo progression, regression, or pseudocavitation is illustrated. Definitive radiographic localization of lesions projecting over the pulmonary fields in patients undergoing hemodialysis is emphasized because of the significantly increased incidence of infection (including tuberculosis), septic embolism, and carcinoma.