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Chronic Eosinophilic Pneumonia With Calcification: An Unusual Pattern of Metastatic Pulmonary Calcification.

Metastatic pulmonary calcification is characterized by the deposition of calcium within the walls of airways, blood vessels, and alveolar septa. We describe a case of intraalveolar metastatic calcification associated with chronic eosinophilic pneumonia, which to our knowledge has not been reported. A 25-year-old woman with a history of asthma and intravenous drug abuse developed severe shortness of breath and diffuse centrilobular ground-glass opacities on computed tomography of the chest. Video-assisted thoracoscopic lung biopsy disclosed a pattern of organizing pneumonia with patchy airspace fibrin and focally prominent eosinophils. Many of the intraalveolar fibromyxoid plugs were invested with calcific deposits, some of which exhibited an associated giant cell reaction. No exogenous foreign material was identified. Concomitantly, the patient developed hypercalcemia secondary to transient acute renal failure of undetermined etiology and was also found to have leukocytosis with peripheral eosinophilia. The lung biopsy findings were interpreted as most consistent with chronic eosinophilic pneumonia with an unusual pattern of concurrent metastatic pulmonary calcification. In 3 months of follow-up, the patient has responded only marginally to corticosteroids. In addition to airway, vascular, and alveolar septal deposition, metastatic pulmonary calcification can occur within airspaces in association with chronic eosinophilic pneumonia. Patients showing chronic eosinophilic pneumonia with associated intraalveolar calcification on lung biopsy should be examined for hypercalcemia.

J. Sauter (1); H. Tazelaar (2); K. Butnor. (3) (1) Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; (2) Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona; (3) Department of Pathology and Laboratory Medicine, The University of Vermont Medical Center, Burlington.

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Author:Sauter, J.; Tazelaar, H.; Butnor, K.
Publication:Archives of Pathology & Laboratory Medicine
Article Type:Author abstract
Date:Mar 1, 2016
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