cxr: multiple calcifications

PROF MAHESHKUMAR’S UNITDR R VIJAYANAND

55 years old gentleman from Rajasthan comes with h/o recurrent respiratory infectionsNo h/o prior antituberculous therapyNon smoker

Chest xray PA View showingMultiple soft tissue calcificationMultiple healed parenchymal lesions Calcified wormbronchiectasis

Causes for soft tissue calcification

DYSTROPHIC

Diseased tissue

Normal serum CALCIUM Damaged heart valvesTB LYMPH NODESAtherosclerosisStroma of some tumours<psammoma bodies>

METASTATICNormal tissuesDisorder of calcium metabolismCKDHyperparathyroidismSarcoidosisMilk alkali syndromeHyperVitaminosis D

Commonly seen in kidneys<basement membranes>Lungs<alveolar wallsStomach-fundal glandscornea

Soft tissue calcification

Arterial calcification-aging,primary or secondary hyperparathyroidism,werner’s syndrome.

Venous calcification-thrombosed veins, varicose veins

Nerves- leprosy,neurofibromatosis

Haematomas- cephal haematomas

Metabolic - hyperparathyroidism, vit-D overdose, chronic renal failure

Soft tissue necrosis followed by calcification

Subcutaneous fat necrosis & calcification – ehlers danlos syndrome , christian weber syn

Extensive soft tissue calcification in dermatomyositis – ‘calcinosis universalis’

-TB lymph node,Im injections, snakebites,frost bite,

Tendon – supraspinatus tendon

Diffuse systemic sclerosis

Calcification of tumours- haemangiopericytoma, medullary carcinoma of thyroid, thyroid adenoma

Parasitic calcification-guinea worm, loa loa, cysticercus cellulosae, trichinella spiralis

Guinea worm [Dracunculensis medinensis]Vector borne nematode infestation of soft

tissueCommon in gujarat, rajasthanLast case in india july - 1996India declared free of guinea worm - 2000

LIFE CYCLE drinking water infected

With cyclops

Man acquires infection

Larvae released & penetrate the duodenal wall

Larvae Mature&reproduce

Migrates through viscera to subcutaneous tissues

Fertilzed female worm migrates to skin surface

Causes blister ruptures releases larvae

Where stepwells are the source of water supply

Transmission occursEradication is possible

by provision of safe drinking water, control of cyclops,health education

Treatment – Niridazole,Mebendazole,Metronidazole

SOFT TISSUE SWELLINGS

WORM FROM BLISTER

References Sutton textbook of radiologyPark textbook of social&preventive medicineFishman textbook of respiratory diseasesInternetRobbins textbook of pathology