Carlos S. Restrepo MD, Presenter: Nothing to Disclose

Michael James McCarthy MD, Abstract Co-Author: Nothing to Disclose

Amy Laura Mumbower MD, Abstract Co-Author: Nothing to Disclose

Rashmi S. Katre, Abstract Co-Author: Nothing to Disclose

Ameya Jagadish Baxi MBBS, DMRD, Abstract Co-Author: Nothing to Disclose

Jorge Carrillo MD, Abstract Co-Author: Nothing to Disclose

Purpose: To determine the prevalence, imaging and demographic characteristics of Dendriform Pulmonary Ossification (DPO) in patients with diffuse pulmonary fibrosis.

Methods and Materials: DPO is a rare condition characterized by branching bony spicules with bone marrow in the lung parenchyma in association with interstitial pulmonary fibrosis and occasionally in other pulmonary disease. The exact prevalence and demographic characteristics of patients with DPO is not known. The database of this single-center lung transplant program was retrospectively reviewed for patients having had lung transplantation for pulmonary fibrosis during the last 15 years. 156 patients with pulmonary fibrosis were reviewed. A pre-transplant lung CT was available for analysis in 124 patients. DPO was considered  present when bilateral multiple small pulmonary parenchymal calcifications were present. Their predominant location and distribution was determined as well as the overall predominant pattern of pulmonary fibrosis. The clinical and demographic composition of this subsets of patient was compared with that of the population at large with pulmonary fibrosis.

Results: The gender distribution of patients with pulmonary fibrosis was 61% males,39% females with average age at the time of  pre-lung transplant CT of 55.7 years. DPO was seen in 11s patients (8.9%). Nine of the eleven patients were males (81.8%). The average age of DPO patients was 59.  CT pattern of pulmonary fibrosis in patients with DPO was NSIP in 5  and UIP in 6 cases, whereas in the overall pulmonary fibrosis population NSIP was seen in only 24% and UIP / possible UIP in 76% . Distribution of DPO was bilateral in all cases and predominantly in the periphery of the mid and lower lung zones. . Even though nodular and branching calcification were usually present in the same patients, at least one dendriform or branching calcification was present in every patient.

Conclusion: DPO in patients with diffuse pulmonary fibrosis has a prevalence of less than 10%, typically affects males, and may be found in patients with either UIP or NSIP pattern of pulmonary fibrosis.

Clinical relevance: Dendriform pulmonary ossification (DPO) is an uncommon complication of patients with diffuse pulmonary fibrosis, and can mimic numerous conditions in which multiple lung calcifications are present.

Restrepo, C, McCarthy, M, Mumbower, A, Katre, R, Baxi, A, Carrillo, J, Dendriform Pulmonary Ossification in Pulmonary Fibrosis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011063.html