Long-term Follow-up of Ectopic Pulmonary Calcification Diagnosed by a Transbronchial Lung Biopsy

Abstract

Background. Ectopic calcification is characterized by diffuse calcium deposition in various organs. Its main cause is chronic kidney disease. The pathogenesis and clinical course have not yet been fully elucidated. Case. A 59-year-old man was referred to our hospital due to the appearance of bilateral ground-glass opacities (GGOs) on chest CT findings. He had been on hemodialysis for chronic kidney disease since 1992 but had stopped it following deceased donor renal transplantation in 2006. We performed bronchoscopy and a transbronchial lung biopsy (TBLB) for the bilateral GGOs. A histopathological analysis of the TBLB specimens revealed calcification of lung tissue. Given the pathological analysis findings and his clinical background, he was diagnosed with ectopic pulmonary calcification. Computed tomography (CT) findings revealed gradual enlargement and densification of the GGOs, suggesting the progression of calcification. He is scheduled for parathyroidectomy to prevent calcification. Conclusion. Bronchoscopy is useful for the diagnosis of ectopic pulmonary calcification by helping to rule out other diseases and is also a less-invasive method of performing a histopathological evaluation. The present case is unique with respect to the long-term follow-up of chest CT findings due to ectopic pulmonary calcification.