Uncategorized

Calcification

The Common Vein Copyright 2007

Ashley Davidoff MD

 

 

CT vs MRI
These two images represent cross sectional imaging of an infrarenal fusiform abdominal aortic aneurysm, with image a, being from a T1 weighted MRI sequence and image b from a CT scan with contrast. MRI fails to have the sensitivity for calcium that CT does, and since calcification is an intrinsic part of aneurysmal disease, when it comes to meausurement of aortic aneurysmal size, CT is superior. Courtesy Ashley Davidoff MD 15153c code CVS aorta abdomen AAA aneurysm fusiform infrarenal

 

Head and Neck

 

Osteoma
29107 44F one occiput occipital bone fx mass ossified dx osteoma neoplasm benign CTscan Davidoff MD

Osteoma

Imaging findings

Size – usually less than 2 cm in size

Shape- looks like half a billiard ball

Position – Mist frequent in the frontal and ethmoid sinuses

Well-circumscribed, sharply-marginated round and

outer table of the skull

Seen in the auditory canals of swimmers and divers

 

Character  – very dense lesions of dense compact bone

 

Associated findings – multiplicity – Gardners

Notes

Most common tumor of the paranasal sinuses

Benign tumor of membranous bone consisting of dense, compact bone

 

Metastattic Calcification in Hypeparathyroidism
The plain film of the chest is from a 31 year old female with hyperparathyroidism and shows clumped calcifications in the right axilla consistent with metatstattic calcification of soft tissues. The presence of the prosthesis and the asymmetry of the accumulation suggests that the trauma of surgery needs tobe implicated in the pathogenesis. The surgical clips in the mediastinum seen better on the zoomed image on the right reflects surgical footprints of a parathyroidectomy.

chest muscle calcification calcified Courtesy Ashley DAvidoff MD copyright 2009 all rights reserved chest axilla fx calcification dx dystrophic calcification dx hyperparathyroidism plainfilm 24656c.8s
15537b07
15537b07 hx 75F with left shoulder pain heart left humerus left shoulder fx cartilagenous popcorn type calcification dx chondrosarcoma chondrogenic sarcoma of the shoulder with metastasis to the RV right ventricle malignant imaging radiology plain film Courtesy Ashley Davidoff MD

15537b08
15537b08 hx 75F with left shoulder pain heart left humerus left shoulder fx cartilagenous popcorn type calcification dx chondrosarcoma chondrogenic sarcoma of the shoulder with metastasis to the RV right ventricle malignant imaging radiology plain film Courtesy Ashley Davidoff MD

42195c01
42195c01 Courtesy Ashley Davidoff MD medical students code calcification eggshell calcification hila hilum lung lymph node mediastinum saracoidosis

33472b01.800
33472b01.800 chest lung lymph node mediastium mediastinal intraparenchymal lymp node fx eggshell calcificaton dx probable sarcoidosis CTscan Davidoff MD

29125c
This collage of a plain film and a CT of sarcoidosis characterised by confluent fibrosis and characteristic egg- shell calcification. Note the upper lobe predominance. Courtesy Ashley Davidoff MD. 29125

+

30252
This CT shows a prominent calcification in the right middle lobe, consistent with granulomatous disease, either TB or histoplasmosis. Note however that the calcification is eccentric and thus it is essential to follow this up on the 3/6/12month/1 year protocol. The presence of a calcified ipsilateral hilar node in this case makes granulomatous disease more likely. (30249 30252 30252c)

31491
31491 lung fx mass lung nodule fx calcified calcifications dx rectal carcinoma complicated by pulmonary metastasis CTscan Courtesy Ashley DAvidoff MD

Psammomatous Calcification – Ovarian Carcinoma
03779.800 liver metatstasis primary ovarian cancer adenocarcinoma psammomatous calcifications psammoma bodies glandular malignancy histopathology Davidoff MD

30325
This CT demonstrates a calcified anterior mediastinal mass. The mass proved to be lymphoma. Calcification of lymphoma prior to therapy is quite unusual. Courtesy Ashley Davidoff MD. (30321 30325)

32017c
This combination image is a CT through a mass in the LUL showing focal pleural calcification overlayed in green (2) in this patient with asbestos related disease. A pneumothorax followed the biopsy revealing that the pleural plaques are positioned on the parietal pleura.(3,4) A small amount of air introduced from the xylocaine injection outlines the parietal pleura.(5,6) Courtesy Jorge Medina MD. 32017c.jpg

01313
Courtesy Barbara Banner MD 01313 code esophagus mass calcified calcification leiomyoma imaging radiology contrast X-Ray plain film CXR chest

01312
Courtesy Barbara Banner MD 01312 code esophagus mass calcified calcification leiomyoma barium swallow upper GI UGI imaging radiology contrast X-Ray

01314
Courtesy Barbara Banner MD 01314code esophagus mass calcified calcification leiomyoma grosspathology

01316
Courtesy Barbara Banner MD 01316 esophagus mass calcified calcification leiomyoma histopathology

00644
00644 stomach gastric fx calcified mass calcification dx leiomyosarcoma upper GI UGI imaging radiology contrast X-Ray Courtesy Ashley Davidoff MD

00645
00645 stomach gastric fx calcified mass calcification dx leiomyosarcoma imaging radiology CTscan Courtesy Ashley Davidoff MD

00645b
00645b stomach gastric fx calcified mass calcification dx leiomyosarcoma imaging radiology CTscan Courtesy Ashley Davidoff MD

Abdominal Cavity

30368
30368 small bowel fx encased abdomen peritoneal space peritoneum fx calcification loculated ascites dx ovarian carcinoma complicated transperitoneal metastasis CTscan Courtesy Ashley Davidoff MD DB

30370
30370 small bowel fx encased abdomen peritoneal space peritoneum fx calcification loculated ascites dx ovarian carcinoma complicated transperitoneal metastasis CTscan Courtesy Ashley Davidoff MD DB

30252 c
This CT shows a prominent calcified node in the right hilum, and a calcification in the RML consistent with granulomatous disease, either TB or histoplasmosis. In this case the calcification in the lung is eccentric and hence it has to be closely followed, although given the calcified hilar node malignancy is extremel unlikely. (30249 30252 30252c) code lung pulmonary nodule calcified eccentric calcification lymph node hilum hilar granuloma granulomatous disease imaging radiology CTscan

 
This is a CT scan show a cavitating mass in the superior segment of the left lower lobe, that also has an eccentric calcification. This is a classical example of squamous cell carcinoma of the lung. The calcification is unusual. Courtesy Ashley Davidoff MD. code lung pulmonary mass calcification eccentric cavitating cavitary neoplasm malignant primary malignancy carcinoma imaging radiology CTscan cavitation
22992
22992 liver + capsule + spleen small bowel stomach abdomen peritoneum peritoneal cavity fx mass + fx calcification + dx pseudomyxoma peritonei + imaging radiology CTscan Courtesy of Ashley Davidoff MD DB

 Gastrointestinal Tract

22913
22913 jejenum fx mass fx cystic fx calcification dx small bowel duplication imaging radiology CTscan Courtesy Ashley Davidoff MD DB

 

31118
31118 hx 75 F small bowel fx dilated fluid filled fx calcification dx SBO gallstone ileus CTscan Courtesy Ashley Davidoff MD DB

 

31123
31123 hx 75 F small bowel fx dilated gallbladder fx calcifcation fx air dx SBO gallstone ileus CTscan Courtesy Ashley Davidoff MD DB

Hyperplastic Cholecytoses Aschoff Rokitansky Sinus
19701 gallbladder + wall + fx calcification + cholecystoses + hyperplastic cholecystoses cholesterolosis imaging radiology CTscan Aschoff -Rokitansky sinuses

Dx Hyperplastic Cholecystoses

Adenomyomatosis is an idiopathic, tumor-like abnormality of the gallbladder that is manifested by various hyperplastic changes such as overgrowth of the mucosa and thickening of the muscular wall. There is also development of intramural diverticulae, crypts, and sinus tracts within the gallbaldder wall called Rokitansky-Aschoff sinuses. These sinuses may be visible on ultrasonography by demonstration of ring-down artifacts that appear like “comet-tails”.

There is no malignant potential and the condition may involve the gallbladder in a focal, segmental, or diffuse form. Differentiation from gallbladder carcinoma may be difficult in some cases.

19385
19385 liver + fx calcification + granulomatous disease + imaging radiology CTscan infection hot seat TB histoplasmosis code bile duct dilated
19394c01
19394c01 code pancreas pancreatic head uncinate process fx mass fx central calcification dx serous cystadenoma code pancreatic duct fx dilated code fx calcifications dx granulomatous disease spleen code kidney fx small + imaging radiology CTscan code mass neoplasm benign tumor
32913
32913 Courtesy Ashley Davidoff MD abdomen calcification pancreas calcified body tail uncinate process chronic pancreatitis dystrophic calcification medical students inflammation imaging radiology KUB radiologists and detectives
32915b01
32915b01 Courtesy Ashley Davidoff MD abdomen calcification pancreas calcified body tail uncinate process chronic pancreatitis dystrophic calcification medical students inflammation imaging radiology KUB radiologists and detectives

32916
32916 Courtesy Ashley Davidoff MD abdomen calcification pancreas calcified body tail uncinate process chronic pancreatitis dystrophic calcification medical students inflammation imaging radiology lateral abdomen aorta radiologists and detectives

26076
26076 Courtesy Ashley Davidoff MD code pancreas code bile duct + fx filling defects + fx calcifications + dx cholelithiasis + dx gallstone pancreatitis + imaging radiology CTscan C+

26079c01
26079c01 Courtesy Ashley Davidoff MD code pancreas + fx indurated + dx gallstone pancreatitis + imaging radiology CTscan C+ code bile duct + fx filling defects + fx calcifications + dx cholelithiasis + dx gallstone pancreatitis + imaging radiology

20889
20889 code spleen + hilum + capsule + fx calcification + metastatic primary ovary + carcinoma + imaging radiology CTscan C- liver parenchyma capsule + fx calcification + nodule metastatic primary ovary ligamentum venosum fx calcium calcification dx metastatic primary ovary neoplasm malignant metastasis metastases cancer tumor skin third spacing pleural effusion

16868
16868 diaphragm liver porta hepatis gastrohepatic ligament Glissons capsule + fx calcification + primary ovary + metastasis + imaging radiology CTscan neoplasm malignant carcinoma tumor cancer

16869
16869 Punctate calcifications on the liver capsule pleura and diaphragm are noted on this chest CT. The patient has metastatic ovarian carcinoma to the pleura and pericardium with calcification. Courtesy Ashley Davidoff MD. code diaphragm liver porta hepatis gastrohepatic ligament Glissons capsule + fx calcification + primary ovary + metastasis + imaging radiology CTscan neoplasm malignant carcinoma tumor cancer spleen splenic

 

22357.800
22357.800 51 M hepatic bare area liver abdomen ascites fx mass fx stippled calcification calcified fx psammomatous psamomatous calcifications dx metastattic mucinous adenocarcinoma of the rectum CTscan soft tissue windows Davidoff MD 22359 22357.800

22359
22359 51 M hepatic bare area liver abdomen ascites fx mass fx stippled calcification calcified fx psammomatous psamomatous calcifications dx metastattic mucinous adenocarcinoma of the rectum CTscan soft tissue windows Davidoff MD 22359 22357.800

18126
18126 liver + fx mass + fx calcification + bile duct + cholangiocarcinoma + imaging radiology CTscan splenic early heterogeneous contrast enhancement

Gallbladder

16225
16225 Courtesy Ashley DAvidoff MD code gallbladder + infundibulum fx calcification dx cholelithiasis code cystic duct fx dilated fx enhancingwall dx obstruction code abdomen retroperitoneum Gerota’s fascia fx indurated dx gallstone pancreatitis + imaging radiology CTscan

16225c
16225c Courtesy Ashley Davidoff MD code gallbladder + infundibulum fx calcification dx cholelithiasis code cystic duct fx dilated fx enhancingwall dx obstruction code abdomen retroperitoneum Gerota’s fascia fx indurated code pancreas pancreatic uncinate process fx indurated bile duct fx dilated fx enhancing wall fx calcification stone dx choledocholithiasis dx gallstone pancreatitis + imaging radiology CTscan

18378
18378 Courtesy Ashley Davidoff MD code pancreas + fx mass + fx calcification + serous cystadenoma von Hippel Lindau + imaging radiology CTscan C-

Cystic Renal Celll Carcinoma
05730.800 kidney renal mass fx coarse calcifications curvilinear linear calcified space occupying displacement cystic enhancing septations dx cystic renal cell carcinoma RCC CTscan Davidoff MD Bosniak grade 4 05730.800 05730b.800 05729b

Cystic Renal Cell Carcinoma
05729b kidney renal mass space occupying displacement cystic dx cystic renal cell carcinoma RCC grosspathology CTscan Davidoff MD Bosniak grade 4 05730.800 05730b.800 05729b

 

Nephrolithiasis and  Milk of Calcium Urine
16045 kidney renal nephrolithiasis fx calcifications calcified fluid fluid level dx milk of calcium urine CTscan Davidoff MD 16046b01 16046

16808
16808 kidney fx renal mass fx punctate calcification RCC renal cell carcinoma malignant cancer pancreas head and uncinate process aging fatty atrophy of dorsal portion CT scan

16808b01
16808b01 kidney fx renal mass fx punctate calcification RCC renal cell carcinoma malignant cancer pancreas head and uncinate process aging fatty atrophy of dorsal portion CT scan

26477b02
26477b02 Courtesy Ashley Davidoff MD pancreas anatomy lymph node lymphatic drainage fx calcified calcification dx sarcoidosis kidney mass calcification calcified imaging radiology CTscan

40406c
40406c Courtesy Ashley Davidoff MD code lung fx interstium fx thickening dx interstitial lung disease ILD code pancreas abdomen lymph nodes fx calcified code brain meninges fx calcifications code dx sarcoidosis imaging radiology CT scan code inflammation immune

Bladder

Is the stone in the Bladder or Ureter? Use of Gravity
16046 urinary bladder fx calcification calcified lying posterior and midline dx recently passed stone CTscan Davidoff MD 16046 16046b01

17108
17108 urinary bladder dome anterior wall calcification dx urachal remnant calcification CTscan Davidoff MD

17102
17102 44F with hematuria fx anterior bladder mass fx calcification fx mass dx urachal adenocarcinoma imaging CTscan Courtesy Ashley Davidoff MD

 

20068
20068 44M with hematuria fx anterior bladder mass fx calcification dx urachal adenocarcinoma imaging CTscan Courtesy Ashley Davidoff MD

16568
16568 urinary bladder nodule fx relatively hypodense fx contrast in bladder dx bladder stone calculus CTscan Davidoff MD

16758
16758 urinary bladder nodule fx relatively hypodense fx contrast in bladder dx bladder stone calculus CTscan Davidoff MD

17103
17103 26M syncope on urination urinary bladder mass dense phlebolith dx phaeochromocytoma CTscan Davidoff MD 17106 17103 17104 17105 17106 17107

17106
17106 26M syncope on urination urinary bladder mass dense phlebolith dx phaeochromocytoma MRI T2 Davidoff MD 17106 17103 17104 17105 17106 17107

RES

20730b
20730b spleen + splenic capsule calcified +calcification imaging radiology CTscan

20996b
5 year old male 20996b spleen + fx calcifications multiple nodules + dx infarcts + imaging radiology USscan surgical proof

20995
20995 spleen + fx calcifications multiple calcified nodules + dx multiple splenic infarcts + plainfilm imaging radiology KUB X-ray

20997
5 year old male 20997 spleen + fx calcifications multiple + dx calcified splenic infarctions infarct + plainfilm surgical grosspathology

20919a01
20919a01 spleen + dense thorotrast + celiac axis lymph nodes hyperdense calcific density plainfilm KUB X-ray abdomen infiltrative disorder RES reticuloendothelial system

20919a03
20919a03 spleen + fx dense hyperdense fx nodule dx Thorotrast + imaging radiology CTscan C- non contrast liver capsule parenchyma calcific density calcification calcified gastrohepatic ligament lymph node fx hyperdense calcified infiltrative disease retciculoendothelial system RES rule out angiosarcoma

20921
20921 spleen + fx dense hyperdense parenchyma dx Thorotrast + imaging radiology CTscan C- non contrast liver dense hyperdense parenchyma calcific density calcification calcified infiltrative disease retciculoendothelial system RES

20924
20924 gallbladder fossa GBF + fx calcification + Thorotrast + imaging radiology CTscan liver dense hyperdense parenchyma calcific density calcification calcified infiltrative disease retciculoendothelial system RES

20914
20914 hx 75F lymph node fx large calcified metastaic dx carcinoid tumor imaging radiology CTscan C- Courtesy Ashley Davidoff MD DB

 

  • Rarely, large osteoma in the frontal or ethmoid region may displace globe forward and cause proptosis
  • Obstruction of a sinus ostium may lead to infection or formation of a mucocele
  • Very rarely, an osteoma may erode through the dura leading to cerebrospinal fluid rhinorrhea or intracranial infection

Multiple osteoma of the mandible and maxilla, along with the frontal, sphenoid and ethmoid sinuses, rarely the long bones or phalanges

Cutaneous and soft tissue tumors

Association between colonic polyps with a predilection to malignant degeneration

Other Images

 Learning Radiology.com

Bone Tumor.org

References

Gardners Syndrome – eMEdicine

 

Cardiovascular System

 

15401
This CTscan with contrast through the heart shows heavy calcification of the LAD as well as the circumflex coronary artery as well as calcification of the aortic annulus. Courtesy Ashley Davidoff MD. 15401 code cardiac heart artery coronary calcification calcium calcified CAD atherosclerosis aortic sclerosis annulus imaging radiology CTscan AO aorta

Pericardial Calcification
15527 heart pericardium fx calcification serous pericardium fibrous pericardium dx calcific pericarditis probable viral in origin imaging radiology CTscan Courtesy Ashley Davidoff MD

Pericardial Calcification
29157 hx 55M with cough fx heart pericardium epicardium visceral pericardium parietal pericardium fx calcification dx calcific pericarditis probable viral virus imaging radiology plain film CXR Courtesy Ashley Davidoff MD

Amyloidosis
15528 heart + pericardium + fx calcification + amyloid + imaging radiology CTscan infiltrative amyloidosis

Amyloidosis
abdomen + pericardium + fx calcification + amyloid + imaging radiology CTscan infiltrative amyloidosis

LV Apical Aneurysm
This cross sectional CT image of the heart shows calcified apex of the left ventricle associated with thrombus, characteristic of an LV aneurysm. The cause is almost certainly secondary to coronary artery disease and ischemic heart disease with secondary myocardial infarction.

Courtesy Ashley Davidoff MD. 30472 code heart LV apex IHD CAD aneurysm calcification calcified MI cardiac imaging radiology CTscan

LV Apical Aneurysm Post Infarction
This single cross sectional view of the heart through the LV shows apical myocardial dystrophic calcification. The pericardium can be seen as a fine soft tissue density between the two layers of fat – the epicardial fat (inner layer) and the pericardial fat. This finding is diagnostic of a previous MI and may represent dystrophic calcification in the myocardium or within thrombus in an aneurysm of the apex. Courtesy Ashley Davidoff MD. 29600 code CVS cardiac heart MI apex calcification calcified IHD myocardium cardiac imaging radiology CTscan

29601
This single axial CT image shows a faint lucurvilinear lucency in the apical myocardium. This lucency is thought to be a fatty deposition in infarcted myocardial tissue. The calcification in the annulus is premature and unusual for this 56 year old male patient. Note the small bilateral pleural effusions. Courtesy Ashley Davidoff MD. 29601 code CVS cardiac heart MAC apical fat MI cardiac imaging radiology CTscan

Papillary Muscle
The chest CT is taken through the heart with the contrast phase in the right sided structures. A focal calcification in the cavity of the left ventricle (LV) is seemingly related to a focal hypodensity of the paillary muscle and may represent a calcific nodule on the chotdae or papillary muscle tip. Courtesy Ashley Davidoff MD 26320 code LV papillary muscle calcification chordae tendinae cardiac imaging radiology CTscan

24672
This is a CT of the chest at the level of the heart filmed on narrow windows showing a dense ventricular septum. The autopsy specimen showed calcific myocarditis. Courtesy Ashley Davidoff MD 24672 code heart septum dense calcific calcified calcification myocarditis inflammation cardiac imaging radiology CTscan
15529
15529 abdomen + gastrolienal ligament +spleen stomach fx calcification + amyloid + imaging radiology CTscan amyloidosis infiltrative

19426c
This series of images are from a CTscan showing an ascending aortic thoracic aneurysm. There is evidence of heavy calcification of the aortic valve (aortic sclerosis), an aneurysm confined to the ascending aorta (b,c,d), and tortuosity of the descending aorta (d). The cause for the aneurysm is probably a combination of systemic hypertension, aortic stenosis and atherosclerotic degeneration of the wall. Courtesy Ashley Davidoff MD 19426c code CVS thorax aorta ascending aneurysm MAC aortic sclerosis CTscan

22734 cW02
This angiogram of the abdominal aorta shows a widened infrarenal aorta. At first glance the lumen of the aorta appears normal, but a faint curvilinar calcification of the true wall can be seen to the patients left in the first image. The second image (b) reveals the true size of the aneurysm. Courtesy Ashley Davidoff MD 22734 cW02 codeCVS aorta artery abdomen aneurysm AAA

33289
This conventional gray scale US of the neck shows a common carotid artery heaped up plaque on the far wall causing stenosis of moderate degree. Note also the linear area of strong echogenicity on the far wall associated with shadowing consistent with a calcification in the wall. These findings are characteristic of atherosclerotic plaque. Courtesy Philips Medical Systems 33289

15537b01
15537b01 hx 75F with left shoulder pain heart fx calcification ddx question calcific pericarditis probable dx metastatic chondrosarcoma imaging radiology plain film Courtesy Ashley Davidoff MD

15537b03
15537b03 hx 75F with left shoulder pain heart lung fx calcification fx parenchymal infiltrate fx pleural effusion dx small pulmonary infarct small Hamptons hump dx metastatic chondrosarcoma metastasis osteogenic sarcomatous malignant pulmonary emboli embolus imaging radiology CTscan Courtesy Ashley Davidoff MD

15537b04d
15537b04d hx 75F with left shoulder pain heart lung fx calcification fx parenchymal infiltrate fx pleural effusion dx small pulmonary infarct small Hamptons hump dx metastatic chondrosarcoma metastasis osteogenic sarcomatous malignant pulmonary emboli embolus imaging radiology CTscan Courtesy Ashley Davidoff MD

Gardner?s syndrome