Recognition and significance of pulmonary bone embolism

Embolism of bone marrow to the lungs is a quite frequent finding after trau ma but transport and deposition of solid bone is rarely seen, which may sim ply be because pulmonary calcifications are not recognized as bone fragment s. We report on three patients with embolism of bone spicules to small lung arteries of about 0.5 mm in diameter which were plentiful in two of the pa tients on postmortem examination. However. the true nature of the emboli wa s only recognizable after decalcification of lung tissues. It appears that trauma occurring in a septic bone lesion has the greatest c hance to provoke bone embolism. The bone spicules do not usually occlude ve ssel lumina and thus do not severely disturb the blood circulation in the l ungs. The bone fragments become covered by endothelium and can remain recog nizable for months or even years.