METASTATIC PULMONARY CALCIFICATION IN PATIENTS WITH HYPERCALCEMIA - FINDINGS ON CHEST RADIOGRAPHS AND CT SCANS

OBJECTIVE. The objective of this study was to characterize the finding s on chest radiographs and CT scans in patients with metastatic pulmon ary calcification due to hypercalcemia. MATERIALS AND METHODS. The che st radiographs and CT scans of seven patients with biopsy-proved metas tatic pulmonary calcification were reviewed by two observers. Metastat ic calcification was due to chronic renal failure (n = 4), T-cell leuk emia (n =1), multiple endocrine neoplasia type I syndrome (n = 1), and idiopathic hypercalcemia (n = 1). RESULTS. Numerous nodular opacities measuring 3-10 mm in diameter were seen on the chest radiographs in f ive cases, and patchy areas of parenchymal opacification were seen in two cases. Calcification of the nodules was evident in two cases. On C T scans, pulmonary nodules were present in all seven cases. These nodu les were predominant in the upper lung zone in three cases, were diffu se in three cases, and were predominant in the lower lung zone in one case. Calcification of the nodules was evident on the CT scans in four of the seven cases, and calcification of vessels in the chest wall wa s evident in six of seven cases. Other findings on CT scans included d iffuse areas of ground-glass attenuation (n = 3) and patchy consolidat ion (n = 2). CONCLUSION. Numerous small nodules are the most common fi nding on the chest radiographs of patients with metastatic pulmonary c alcification. The calcific nature of the nodules is seldom obvious, ho wever. Pulmonary nodules are also the most common finding on CT scans, where the calcific nature of the nodules is more readily apparent. Ad ditionally, calcification is often seen in the vessels of the chest wa ll on CT scans. The combination of calcified nodules and calcified ves sels in the chest wall on CT scans may be characteristic.