Author of

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  P3.18 - Poster Session 3 - Pathology (ID 177)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

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    P3.18-004 - Pulmonary ossifications: To be considered in the differential diagnosis of solitary pulmonary nodules. (ID 1547)

    09:30 - 09:30  |  Author(s): J.F. Gielis
    • Abstract

    Background
    Hetertopic bone formation in the lung, or pulmonary ossification, has been regarded so far as an extremely rare, post-mortem finding without much clinical significance. Two types of ossification are discerned in the literature: nodular ossifications, with a smooth and round edge, which are found in the alveoli themselves, and dendriform ossifications, branching through the alveolar septa, which sometimes even contain marrow formation. Nodular ossifications are associated with congestive heart failure, while dendriform ossification is related to inflammatory and interstitial lung diseases.

    Methods
    In five years time (January 2008 to March 2013), we have diagnosed 17 cases of pulmonary ossifications by awareness of the surgeon and the pathologist. The diagnosis was made in each case after pathological examination. Neither peroperative palpation nor CT by an experienced radiologist were able to differentiate these ossifications from solid tumors.

    Results
    76% of patients were male with a mean age of 65.7±4.0 years. Pulmonary ossifications occurred predominantly in the left lower lobe (35.3%) and the majority were nodular (64.7%) with a mean diameter of 3.5±0.88 mm. Pathological diagnosis in 9 cases could not reveal any pulmonary neoplasm despite strong pre-and preoperative indications. We have observed no clear association between specific pathologies and the presence of pulmonary ossifications.

    Conclusion
    These findings suggest that pulmonary ossifications are not as seldom as believed in the past, and may often be overlooked or mistaken for a malignant space-occupying lesion. Further research on the origin and pathogenesis of these ossifications and increased awareness may be useful. PO may be included in the differential diagnosis of a solitary pulmonary nodule and we expect the prevalence to rise in a population that continues to grow older.