title: Metastatic pulmonary calcification: state-of-the-art review focused on imaging findings.
abstract: Metastatic pulmonary calcification (MPC) is a subdiagnosed metabolic lung disease that is commonly associated with end-stage renal disease. This interstitial process is characterized by the deposition of calcium salts predominantly in the alveolar epithelial basement membranes. MPC is seen at autopsy in 60-75% of patients with renal failure. It is often asymptomatic, but can potentially progress to respiratory failure. Chest radiographs are frequently normal or demonstrate confluent or patchy airspace opacities. Three patterns visible on high-resolution computed tomography have been described: multiple diffuse calcified nodules, diffuse or patchy areas of ground-glass opacity or consolidation, and confluent high-attenuation parenchymal consolidation. The relative stability of these pulmonary infiltrates, in contrast to infectious processes, and their resistance to treatment, in the clinical context of hypercalcemia, are of diagnostic value. Scintigraphy with bone-seeking radionuclides may demonstrate increased radioactive isotope uptake. The resolution of pulmonary calcification in chronic renal failure may occur after parathyroidectomy, renal transplantation, or dialysis. Thus, the early diagnosis of MPC is beneficial. The aim of this review is to describe the main clinical, pathological, and imaging aspects of MPC.
authors: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: lubelem@globo.com.
authors: Luciana Camara
authors: LC
authors: Belém
authors: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: glauciazanetti@gmail.com.
authors: Gláucia
authors: G
authors: Zanetti
authors: Medical School of Rio Preto and Ultra X, São José do Rio Preto, SP, Brazil. Electronic address: asouzajr@gmail.com.
authors: Arthur Soares
authors: AS
authors: Souza
authors: Santa Casa de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. Electronic address: brunohochhegger@gmail.com.
authors: Bruno
authors: B
authors: Hochhegger
authors: AC Camargo Cancer Center, São Paulo, Brazil. Electronic address: marcosduarte500@gmail.com.
authors: Marcos Duarte
authors: MD
authors: Guimarães
authors: Santa Catarina Federal University, Florianópolis, Brazil. Electronic address: luizfelipenobresc@gmail.com.
authors: Luiz Felipe
authors: LF
authors: Nobre
authors: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; D'OR Institute for Research and Education, Rio de Janeiro, Brazil. Electronic address: rosana.souzarodrigues@gmail.com.
authors: Rosana Souza
authors: RS
authors: Rodrigues
authors: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: edmarchiori@gmail.com.
authors: Edson
authors: E
authors: Marchiori
mesh_terms: D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Imaging; Lung diseases; Metabolic diseases; Metastatic pulmonary calcification