DIFFUSE PULMONARY CALCINOSIS WITHOUT CALCIUM-METABOLISM ABNORMALITIESIN A RENAL-TRANSPLANT RECIPIENT

Eighteen years after an uneventful renal transplantation, the chest ra diograph of an asymptomatic 50 year old man showed diffuse bilateral i nfiltrations, predominately at the right apex. Computed tomography (CT ) scan demonstrated a diffuse alveolar pattern, the alveoli being fill ed with a very dense material, with some tracheal calcifications. Bron choalveolar lavage fluid analysis was normal, but bronchial and transb ronchial biopsies revealed calcium deposits in the bronchial mucosa an d in the alveolar septa. The diagnosis of diffuse pulmonary calcinosis was established, despite normal blood calcium, phosphorus and magnesi um levels, based upon computed tomography scan and pathological findin gs at fibreoptic bronchoscopy, without the need for an open lung biops y.