© 2004 BMJ Publishing Group Ltd & British Thoracic Society
Images in Thorax
Idiopathic diffuse pulmonary ossification
1 Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
2 Department of Pathology, University of British Columbia, Vancouver, BC, Canada
3 Department of Radiology, University of British Columbia, Vancouver, BC, Canada
Correspondence to:
Correspondence to:
Dr C F Ryan
UBC Respiratory Clinic, 2775 Heather Street, Vancouver, BC, V5Z 3J5, Canada; fryan@interchange.ubc.ca
| The first 150 words of the full text of this article appear below. |
A 51 year old man presented with a 1 year history of fatigue and night sweats, cough with clear sputum, central chest discomfort, and mild exertional dyspnoea. A detailed exposure history was negative. Laboratory investigations including tuberculin skin test, white cell count, ESR, C-reactive protein, urea, creatinine and electrolytes, protein electrophoresis, rheumatoid factor, antinuclear antibody, calcium, alkaline phosphatase and liver function tests were all normal. Urinalysis and 24 hour urine calcium excretion were normal. Echocardiography was normal. Detailed pulmonary function tests and arterial blood gases were normal except for an isolated reduction in the transfer factor (73% predicted).
The chest radiograph showed a reticulonodular pattern involving mainly the lower lobes. A high resolution chest CT scan showed a fine nodular pattern with foci of calcification (figs 1A and B
). Transbronchial biopsy specimens were non-diagnostic. Thoracoscopic open lung biopsy was performed. Light microscopic examination revealed multiple foci of bone in
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