Pulmonary Ossification Research Articles

Dendriforn Pulmonary Ossification

Four cases of dendriform pulmonary ossification are reported from postmortem roentgenography of isolated lungs. All showed pathoanatomical evidence of chronic fibrosing, mostly interstitial, rarely intraalveolar pneumonia, besides the typical manifestations of dendriform pulmonary ossification. Microscopy revealed fluid transition from proliferating, interstitially increased connective tissue to fully developed osseous structures. These dendriform structures can be seen in some analogy to the structural pattern of interstitial, bronchovascular as well as septal connective tissue; however, actual topographical correlation between bone structures and blood or lymph vessels could not be safely determined. Our observations suggest that dendriform pulmonary ossification may be interpreted as a rare complication, or special manifestation, of chronic fibrosing interstitial inflammation of the lung.

GENERALIZED EXTENSIVE IDIOPATHIC PULMONARY OSSIFICATON IN A DOG: A CASE REPORT

A 9‐year‐old dog was presented with generalized extensive pulmonary mineralization associated with exertional dyspnea and cyanosis. The differential diagnosis for the pulmonary mineralization included metastaticand dystrophic pulmonary calcification, atypical pulmonary neoplasia, alveolar microlithiasis, idiopathic pulmonary mineralization, and idiopathic pulmonary ossification. The dog was euthanized at the owner's request. The histologic diagnosis was idiopathic pulmonary ossification. No previous report of generalized extensive idiopathic pulmonary ossification was found. Idiopathic pulmonary ossification occurs in man, usually involves a limited area of lung, and is functionally unimportant. The pulmonary ossification in the dog reported here was generalized and associated with severe pulmonary dysfunction. The disease in man and that in the dog in this report do not appear to be directly comparable.

The natural history of pulmonary ossification

Introduction: Pulmonary ossification (PO) is a rare pathologic finding, defined as a widespread heterotopic bone formation within the lungs. PO occurs in two forms. The first form is the nodular circumscribed type; the second form is the racemose or branching type. Males are more often affected than females. PO occurs more commonly in older patients, in the sixth decade. The most common site of occurrence is the basal lobes. Material and Methods: Autopsy of a 65 year old man revealed advanced hepatic cirrhosis. Death resulted from fatal hemorrhage from ruptured esophageal varices. In addition we found widespread PO in both lungs. About 100 tissue samples were taken from the lungs, processed in a histokinetic tissue processor, impregnated with paraplast, and cut into 5 μ sections. The sections were stained as follows: Hematoxylin and Eosin, Verhoef's elastic stain, van Gieson Trichrome stain, Gordon and Sweet's Silver impregnation, Prussian Blue reaction, PAS reaction, Celestin blue, Hematoxylin, Ethanolic-Saffron, Alcian Green (pH 2.8, CHESA) stain reaction. Results: The formation and growth of these bony structures occur as a type of osseous metaplasia of the connective tissue. Mesenchymal cells proliferate in the interstitial tissue and produce osteoid. Insofar as formation and growth take place in the absence of blood vessels, immature (woven) bone is formed. This is true for the nodular circumscribed type of PO. In the branching type of PO blood vessel proliferation is often observed, which results in the formation of mature (lamellar) bone. These mature bone structures often enclose an endosteum-lined marrow cavity which contains fat or red marrow. Finally, we also observed peculiar desmoid-like connective tissue proliferation, which occasionally showed transformation into bone. Discussion: PO occurs in two forms. The nodular cirbumscribed type is composed of osseous and osteoid material without marrow elements. It is usually deposited within the lung septa. The second form is the racemose type. It consists of branching spicules of bone in the alveolar septa. This osseous tissue contains mostly marrow elements. As for the pathogenesis of PO, we believe in heterotopic bone formation resulting from connective tissue proliferation which subsequently undergoes osseous metaplasia. In addition to PO, we found peculiar desmoid-like connective tissue proliferation in the lungs, which occasionally showed transformation into bone. PO appears to be functionally unimportant.

Disseminierte verästelte Lungenverknöcherung, kombiniert mit heterotoper Knochenneubildung im Bereich der Muskulatur

Idiopathic disseminated pulmonary ossification is a rarely recognised condition in which small pieces of marrow containing bone are found in the interstitial tissues of the lungs. The case reported here is unique in showing combination with myositis ossificans circumscripta. The extent of the lung changes was also unusual. The clinical, radiological and histological findings are compared.

Diffuse Pulmonary Ossification

Diffuse pulmonary ossification (DPO) was a complication of "shock lung" after aortic valve replacement in a 52-year-old man. The relationship of DPO to shock lung is discussed. A possible mechanism for this complication is based on the development of a fibrin-platelet-fibroblastic interaction that may establish an intraalveolar lattice for collagen deposition by the fibroblast. The development of acidosis and mechanical forcer may potentiate fibroblastic transformation into an osteoblast. The mechanical forcer may influence the shape of the bone in the lung.

Metaplastic bone formation in the lung.

The nodular form of diffuse pulmonary ossification in association with mitral valve disease is a well known entity in the radiologic literature. The branched form of disseminated pulmonary ossification is less frequently seen. Although the etiology is uncertain, it appears to arise as a result of chronic pulmonary congestion.

A new autosomal-recessive hereditary syndrome. Multiple peripheral pulmonary stenosis, brachytelephalangia, inner-ear deafness, ossification or calcification of cartilages

Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

Disseminated nodular pulmonary ossification in the Hamman-Rich lung.

A case of disseminated ossification in the lungs of a patient with Hamman-Rich syndrome is presented. The incidence of this finding in the syndrome is approximately 9 per cent. Although predisposing factors are known, the ultimate stimulus leading to ossification has not been identified.

Idiopathic disseminated pulmonary ossification.

Idiopathic disseminated pulmonary calcification is an unusual condition in which metaplastic bone, occasionally containing marrow, is laid down in the inter-alveolar, interlobular, and subpleural connective tissue and alveoli of the lung. It is rarely diagnosed radiographically but is occasionally an incidental finding at autopsy. Schinz (11) and Salzman (9) each discussed and illustrated this condition, Schinz among others (3, 8, 14) dividing pulmonary ossification into granular and branched forms. The former is found in association with mitral stenosis and is well documented in the radiological literature as pulmonary ossific nodules in mitral valve disease (4–6, 15). The branched or racemose form, referred to in this article as idiopathic disseminated pulmonary ossification, differs etiologically, clinically, and radiographically from the nodular form and consists of spicules of bone arranged in a reticulated pattern, sometimes described as twig- or branch-like. It is found principally but not exclusiv...

Idiopathic Disseminated Pulmonary Ossification

Idiopathic Disseminated Pulmonary Ossification

Disseminated nodular pulmonary ossification in patients with mitral stenosis.

What seem to be rare complications of common diseases may merely be uncommon because no one accumulates a large number. The unusual combination of disseminated nodular bone formation in the lungs and chronic mitral stenosis is more common in young men. The clinical findings in 4 cases are described and the pathogenesis is discussed.

Pulmonary ossification with cardiac calcification in mitral valve disease.

Pulmonary ossification with cardiac calcification in mitral valve disease.

Pulmonary ossification in patients with mitral stenosis

Seven patients are described with mitral stenosis complicated by pulmonary ossification. All patients had evidence of abnormally high pulmonary vascular pressures, but, since such pressures are common in patients with mitral stenosis while pulmonary ossification is rare, it is apparent that factors other than these must be involved in the production of the bone. There is a coincidental relation between pulmonary ossification and pulmonary h˦mosiderosis, since both occur in patients with abnormally high pulmonary vascular pressures.