Dystrophic Calcification

In chronic infections, residual foamy material and organisms frequently undergo dystrophic calcification, a helpful sign for diagnosis when the foamy exudate is absent [1]. CT scans sometimes show the lesions as punctate or rim-like calcifications [2].

giantcalcif

Figure 1. Nodule with Calcification

This small nodule shows chronic inflammation with fibrosis, a few multinucleated giant cells, and chronic inflammatory cells. Multiple calcifications represent the tombstones of previous organisms and their foamy exudate. The giant cells probably represent a foreign-body reaction to the calcium.

Find 2 multinucleated giant cells.

Find a large dystrophic calcification.

Dystrophic calcification occurs in necrotic tissue: serum calcium and phosphorus levels are normal. (Metastatic calcification occurs in normal tissues when the serum calcium level is elevated.)

Figure 2. GMS Stain of Calcifications

Each of the clusters of organisms shown here with the GMS stain is in a focus of calcification.

References: To return to reference section after viewing abstract, click here before clicking on "abstract".

1. Lee M, Schinella R. Pulmonary calcification caused by Pneumocystis carinii pneumonia. A clinicopathological study of 13 cases in acquired immune deficiency syndrome patients. Am J Surg Pathol 1991; 15:376-380. Abstract

2. Lubat E, Megibow A, Balthazar E, Goldenberg A, Birnbaum B, Bosniak M. Extrapulmonary Pneumocystis carinii infection in AIDS: CT findings. Radiology 1990; 174:157-160. Abstract

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Multinucleated giant cell

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Large focus of dystrophic calcification

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