Pulmonary calcification is a common asymptomatic finding, usually discovered on routine chest X-ray or at autopsy. Please confirm that you are a health care professional. Sometimes only a small area of the pleura is affected. These conditions should be considered if unexpected pulmonary complications including prolonged hypoxemia and recurrent atelectasis develop in the posttransplant period. Metastatic pulmonary calcifications can occur in patients with kidney or hepatic failure, and while usually benign, can lead to restrictive lung disease. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. This indicated that most healthy children with pulmonary calcifications did not have tuberculosis but had mild or asymptomatic histoplasmosis.5 Studies by Palmer6 and Edwards et al7 of military recruits and others subsequently confirmed that a large number of healthy persons may be infected with H. capsulatum early in life, with resultant pulmonary calcifications but little or no clinical illness. If you feel insecure about the condition of the calcified nodules in the lungs, besides, the patient has had an o [teenager OR adolescent ], , MD, Vanderbilt University Medical Center. Researchers believe that microcalcification in the intimal layer starts when smooth muscle cells die. The diameter of the plaques can vary from several millimeters to 10 cm. Coronary Artery Calcification and its Progression: What Does it Really Mean? Marchiori E, Souza AS, Franquet T et-al. Calcified granulomas Symptoms of lung calcification are not obvious, so the disease is difficult to detect. Some signs of lung calcification are similar to other lung diseases such as: Shortness of breath or wheezing Dry cough Unexplained weight loss Calcifying nodules in the lungs may be the initial manifestation of early stage lung cancer. 9-51). We do not endorse non-Cleveland Clinic products or services. Coronary artery calcification is an indicator of coronary artery disease and can give your healthcare provider information to help them assess your cardiovascular risk. o [teenager OR adolescent ], , MD, Vanderbilt University Medical Center, Pleural fibrosis and calcification can be either, Asbestos related Asbestos-Related Pleural Disease Pleural disease, a hallmark of asbestos exposure, includes formation of pleural plaques, calcification, thickening, rounded atelectasis, adhesions, effusion, and mesothelioma. Atherosclerosis is the result of plaque collecting in your arteries, making them narrow. Coronary artery calcification increases the chances that a balloon angioplasty will fail. Over time, people may get symptoms, such as: After age 40, calcium from your bloodstream can settle in parts of your body. o [ abdominal pain pediatric ] 6. Copyright 2023 Elsevier B.V. or its licensors or contributors. DOI: 10.1053/rmed.1999.0716. {"url":"/signup-modal-props.json?lang=us"}, Weerakkody Y, Niknejad M, Bell D, et al. Libson E, Wechsler RJ, Steiner RM. Use for phrases ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. Pediatric Respiratory Medicine (Second Edition), Specialty Imaging: HRCT of the Lung (Second Edition), Grainger & Allison's Diagnostic Radiology Essentials, Pulmonary Disease in the Pediatric Patient With Acquired Immunodeficiency States, Kendig's Disorders of the Respiratory Tract in Children (Ninth Edition), Respiratory System, Mediastinum, and Pleurae1, Pathologic Basis of Veterinary Disease (Sixth Edition), Geographic, travel, and occupational fungal infections, Scleroderma, Raynaud's Phenomenon, and Related Conditions, Dermatological Signs of Internal Disease (Fourth Edition). Get useful, helpful and relevant health + wellness information. 6.2.25, p. 322). Expanding Coverage of Cardiac Computed Tomography for Calcium Scoring. QJM. 4. Occasionally, ossification can occur diffusely in the lung. Calcified lung nodules contain calcium deposits that sometimes form in response to infection. These nodules are most likely noncancerous. The care team may also consider the lung nodule's location when assessing possible risk. Studies suggest that nodules located in the upper lobe of the lung may be more indicative of cancer. The distribution and character of the calcification is important. (https://www.fda.gov/medical-devices/recently-approved-devices/shockwave-intravascular-lithotripsy-ivl-system-shockwave-c2-coronary-intravascular-lithotripsy-ivl), (https://www.ncbi.nlm.nih.gov/books/NBK499916/), Heart, Vascular & Thoracic Institute (Miller Family). Less commonly, it is metastatic (i.e., related to hypercalcemia). If only a small area of a lung is affected, people may not have any symptoms. You may need a procedure to clear calcium deposits out of your coronary arteries or you just may need to pick up heart-healthy habits. Fibrosis and calcification can occur more than 20 years after exposure to asbestos. These include: If you have coronary artery calcification, youre at a high risk of developing coronary artery disease and major adverse cardiovascular events (MACE). Venous thromboemboli (VTE) can occur in the posttransplant period, thus leading to respiratory distress and hypoxemia, but they are uncommon in pediatric patients. Khan AN, Al-Jahdali HH, Allen CM, Irion KL, Al Ghanem S, Koteyar SS. This process can start in your 20s, but your healthcare provider may not see it until theres an amount large enough to show up on imaging. The next case of histoplasmosis was described in Minnesota,2 which like Panama is not in the highest endemic area. Good blood flow is crucial in your coronary arteries because they supply oxygen-rich blood to your heart muscle. Some people are left with minor degrees of pleural thickening, which usually causes no symptoms or impairment of lung function. Any pleural or pericardial surface can be affected, but asbestos-related pleural plaques are usually in the lower two thirds of the thorax and are bilateral. Hepatopulmonary syndrome (HPS) and porto-pulmonary hypertension (PPHTN) are two entities that occur in end-stage liver disease and can significantly improve with liver transplantation. Pulmonary calcification. Atherosclerosis is the result 9-51). Treatment of fibrosis and calcification themselves is generally unnecessary. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495121/). But most lung nodules aren't cancerous. Calcification most often affects the parietal and diaphragmatic pleura and spares the costophrenic sulci and apices. Shockwave Intravascular Lithotripsy (IVL) System with the Shockwave C2 Coronary Intravascular Lithotripsy (IVL) Catheter-P200039. It makes it harder to expand a stent to keep your artery open. It is usually dystrophic (i.e., occurs in areas of necrosis). Intrathoracic calcifications: radiographic features and differential diagnoses. Esophageal disease occurs in the majority of patients with systemic sclerosis, leading to dysphagia, reflux esophagitis, and ultimately, strictures and obstructions. Occasionally, calcifications can develop in parts of the pleura that have been affected by fibrosis. Postinflammatory calcifications are invariably unilateral. o [ pediatric abdominal pain ] Other times large areas of the pleura are affected. Pathology Etiology The most Pulmonary calcification has many causes and varying morphology: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Intravascular lithotripsy was successful in more than 92% of cases, and rotational atherectomy has had a 90% success rate. Pulmonary calcification is a condition in which calcified nodules appear in the lungs round or elliptical in shape. This disease is difficult to detect because the symptoms are not clear. By the time it is discovered, the disease may be serious. Have chronic lung diseases such as tuberculosis, pneumonia, bronchitis, At the time the article was created Yuranga Weerakkody had no recorded disclosures. 5 (2): 67-79. Malignant tumors may engulf a pre-existing granuloma, or Wildfire smoke can cause dangerous levels See your healthcare provider if you need a plan for how to improve your cardiovascular health. Case 2: pulmonary alveolar microlithiasis, Case 3: metastatic pulmonary calcification, View Yuranga Weerakkody's current disclosures, View Mohammadtaghi Niknejad's current disclosures, see full revision history and disclosures, calcifying fibrous pseudotumor of the lung, barium sulfate contrast medium aspiration, differential diagnosis of calcific pulmonary densities, Differential diagnosis of calcific pulmonary densities, Calcified pulmonary (lung parechymal) densities, Differential diagnosis of calcified pulmonary densities, Calcified pulmonary densities (differential). Granulomas are not always calcified. Occasionally, the lung becomes encased with a thick, fibrous pleural peel that limits expansion, pulls the mediastinum toward the side of disease, and impairs pulmonary function. Do I need to have my coronary artery calcification checked? Your healthcare provider has several options to remove the calcifications narrowing your coronary artery. The thymus appears dysplastic with poor corticomedullary demarcation, as well as poorly developed Hassall corpuscles. The TCR repertoire is restricted, and TRECs are low. Although HSCT can replenish the hematopoietic system,30 this does not solve the complex and fatal gastrointestinal (GI) manifestations. Respiratory medicine. Diagnosis is based read more. Pediatric radiology. What Are The Benefits of Getting An Early Lung Cancer Diagnosis? The calcified lung nodule: What does it mean?. Many pulmonary complications that arise pretransplantation may not resolve completely or immediately posttransplantation. Pulmonary calcification also accompanies haemosiderin deposition in the lungs and is therefore found in chronic haemorrhagic conditions such as idiopathic haemosiderosis and the postcapillary pulmonary hypertension of mitral stenosis, lymphangioleiomyomatosis and veno-occlusive disease. And most people in their 20s and 30s wouldnt have a reason to get imaging. o [ pediatric abdominal pain ] Examples include tuberculosis, histoplasmosis, and varicella pneumonitis. Occasionally, computed tomography (CT) is needed. Chest x-ray shows asymmetry of the lungs with thickened pleura (trapped lung). Even if you dont have cardiovascular issues, you can eat less fat, exercise more and avoid tobacco products to help keep yourself healthy. People may not have symptoms,or, if a large area of the pleura is affected, they may have difficulty breathing. Policy. Careful attention should be paid to occupational or recreational exposure to bird droppings or bat guano, since either can act as a growth nutrient for H. capsulatum.8,12 The best, and perhaps the only, way to make a diagnosis of acute symptomatic pulmonary histoplasmosis, which is manifest with fever, chills, myalgia, dyspnea, and hypoxia, is to obtain a history of exposure.12 This would include activities such as cutting down trees that had been known to be bird roosts, destroying chicken coops that had remained unused for a long time, or spelunking in caves known to have large bat populations. You get a score of 0 to 400 or more, with higher scores indicating a larger risk of a heart attack or stroke in 10 years. Calcification produces a dense image on the chest x-ray and almost always involves the visceral pleura. Most Coronary artery calcification makes your arteries stiff and less able to expand and contract. The disease is caused by mutations in the TTC7A gene (OMIM *609332), which encodes a protein containing nine tetratricopeptide repeat (TPR) domains. Some patients are left with minor degrees of pleural thickening, which usually causes no symptoms or impairment of lung function. In the more advanced cases, the lungs appear diffusely distended, pale red or brown in color, and show a rough pleural surface with rib imprints (see Fig. More invasive methods to check your coronary artery calcification include: Although healthcare providers dont have a standard treatment for coronary artery calcification, some are using intravascular lithotripsy to treat severe cases. Severe esophageal disease may lead to weight loss and aspiration pneumonia. When looking for metastatic calcification, it is important to use thin-section CT (1 mm) to minimize volume averaging and to reformat the images using a standard algorithm to minimize artifacts due to the reconstruction algorithm. Last reviewed by a Cleveland Clinic medical professional on 05/09/2022. Posttransplant pulmonary hypertension (PHTN) can occur in those with pretransplant HPS, those with recurrent liver disease, and those with no apparent liver disease and isolated PHTN. Learn more about the Merck Manuals and our commitment to Global Medical Knowledge. 8 (4): 305-8. Other treatments to improve artery blood flow: Rotational atherectomy complications may include: Coronary angioplasty complications may include: You can reduce your risk of coronary artery calcification by treating the problems that put you at risk for it. Because this is not primarily an inflammatory lesion, the term pneumonitis should not be used. WebPMID: 10783928. The loss of normal peristaltic function in the distal portion of the esophagus and the replacement of the smooth muscle by collagen produce the esophageal disease. Nodules may develop in one lung or both. no financial relationships to ineligible companies to disclose. As described in an articulate and entertaining report by Sell,3 Nashville, Tennessee, became the focus for investigation of this fungus. Renal transplant patients may be at higher risk because of manipulation of pelvic veins, although this has mainly been reported in adult patients.175, Bryan Corrin MD FRCPath, Andrew G. Nicholson DM FRCPath, in Pathology of the Lungs (Third Edition), 2011. Symptoms like chest pain usually dont happen until youve had it for a while. Sonavane S, Guleria S, Crowe DR, Steenwyk B, Singh S. Progressive lung calcification after orthotopic heart transplant. Multiple factors contribute to the development of metastatic and dystrophic Cleveland Clinic is a non-profit academic medical center. 1. Exposure to asbestos can lead to pleural fibrosis that affects only a small area, at times with calcification. 2. You may have to pay for this test out of your own pocket. The latest information about heart & vascular disorders, treatments, tests and prevention from the No. Over the next decade an additional 70 or so cases of histoplasmosis were summarized in a review by Meleney; all were of the disseminated form and were fatal.4 A filtrate of the mycelial form of a fungus was used as a skin test to identify subclinical or asymptomatic cases of infection. Call 911 if youre having chest pain, nausea and vomiting, shortness of breath or other signs of a heart attack. You may have one nodule on the lung or several nodules. In severe cases, alveolar calcification prevents lung collapse when the thorax is opened. ), Usually, the pleura is very thin and flexible, but sometimes it becomes thick (develops fibrosis) as a result of, Asbestos exposure (called asbestos-related pleural disease Asbestos-Related Pleural Disease Asbestos is a family of naturally occurring compounds whose heat-resistant and structural properties made it useful for inclusion in construction and shipbuilding materials, automobile brakes read more ). Coronary artery calcification causes less blood to get to your heart muscle. 7. After the procedure, your provider can put in a stent (small metal tube) to keep your artery open. This newer procedure uses a catheter (tube) with a device at the end that sends pressure waves out to make the calcification come apart. Success rates are high, but there are risks with each treatment. It's also a possible complication of other respiratory problems, including cystic fibrosis, A substantial proportion of patients with systemic sclerosis have abnormal pulmonary function tests, which may include reduced vital capacity, impaired carbon monoxide diffusion, and pulmonary hypertension. Calcium deposits start small (.5m or micron/micrometer) and grow to be larger than 3mm with plaque continuing to accumulate at the same time. o [ abdominal pain pediatric ] However, there have been reports of cases throughout the eastern half of the United States and Latin America.8 Infections have also been reported, albeit less commonly, in Europe and in Asia, including Malaysia, Thailand, India, and Indonesia.8,9, Duncan described a different form of histoplasmosis in Africa in 1958.10 The organisms appear the same in the mycelial form, but the yeast form is considerably larger. It also makes it more difficult to put a stent in a position where it would work best. Enter search terms to find related medical topics, multimedia and more. People with coronary artery calcification often dont have any symptoms. Intravascular lithotripsy complications may include: Aneurysm, or a blood vessel thats stretched out. If you have coronary artery calcification, you should follow the recommendations for a heart-healthy lifestyle, including: If you have high blood pressure and/or high cholesterol, you should see your healthcare provider regularly to make sure youre controlling those issues. 3. The fibrotic pleura can also develop calcification (accumulation of calcium within the tissue). Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada)dedicated to using leading-edge science to save and improve lives around the world. Youre more likely to get coronary artery calcification if you have: People who were assigned male at birth also have a higher risk for coronary artery calcification. Radiographs of the chest often show abnormalities with advanced disease, and may show features of fibrosis, cyst formation, and pulmonary calcification. The differential diagnosis for metastatic pulmonary calcification includes pneumonia, sarcoidosis, silicosis, talcosis, amyloidosis, and idiopathic pulmonary ossification. Chest x-rays are done to detect pleural fibrosis and calcification. (See also Overview of Pleural and Mediastinal Disorders Overview of Pleural and Mediastinal Disorders The pleura is a thin, transparent, two-layered membrane that covers the lungs and also lines the inside of the chest wall. WebIs lung calcification dangerous is something many patients wonder. Furthermore, their nodular appearance on chest radiographs can mimic nodules from infection or malignancy (see the previous section). WebPleural fibrosis and calcification are thickening and stiffening of the pleura (the thin, transparent, two-layered membrane that covers the lungs) that occurs as a result of calcifying fibrous pseudotumor of the lung; calcifying pulmonary metastases; amorphous calcifications. Histoplasma capsulatum is the cause of the endemic mycosis histoplasmosis and was first discovered to be a cause of disease in humans by Darling in 1906. The trusted provider of medical information since 1899, Overview of Pleural and Mediastinal Disorders, Reviewed/Revised Jan 2021 | Modified Sep 2022. This happens after you've had plaque (fat and cholesterol) forming in your arteries (atherosclerosis) for about five years. In the case of HPS, significant hypoxemia can occur because of dilation of pulmonary capillaries, and this may persist in the postoperative period, leading to prolonged mechanical ventilation and the use of supplemental oxygen. The link you have selected will take you to a third-party website. We do not control or have responsibility for the content of any third-party site. Primary muscle, joint, and nervous system diseases occur in systemic sclerosis, but are relatively uncommon and may be seen more frequently in patients with overlap syndromes, such as mixed connective tissue disease. Many pulmonary complications that arise pretransplantation may not resolve completely or immediately posttransplantation. Metastatic pulmonary calcificationscan occur in patients with kidney or hepatic failure, and while usually benign, can lead to restrictive lung disease. Advertising on our site helps support our mission. Inflammation or asbestos exposure can cause the pleura to thicken and become stiff. One is pulmonary alveolar microlithiasis, a hereditary disease in which calcified spherules occur within the alveoli. Use to remove results with certain terms Damaged, inflamed or repaired arteries are more likely to attract calcium deposits. This is why women tend to develop atherosclerosis 10 to 15 years later than men. Become a Gold Supporter and see no third-party ads. (https://pubmed.ncbi.nlm.nih.gov/24530667/). Some granulomas, particularly on the skin, can heal by themselves Pleural fibrosis and calcification are thickening and stiffening of the pleura (the thin, transparent, two-layered membrane that covers the lungs) that occurs as a result of pleural inflammation or exposure to asbestos. At the time the article was last revised Mohammadtaghi Niknejad had A hypertensive crisis may develop suddenly in patients with systemic sclerosis, and may quickly precipitate renal failure. Alfonso Lpez, Shannon A. Martinson, in Pathologic Basis of Veterinary Disease (Sixth Edition), 2017. Interstitial ossification is rare but has been occasionally reported in cases of idiopathic pulmonary fibrosis and long-term busulfan therapy. Cutting, scoring or high-pressure balloon. 94 (3): 190-3. Enter search terms to find related medical topics, multimedia and more. WebPolicy Coronary artery calcification vs. atherosclerosis The amount of calcification you have is an indicator of how bad your atherosclerosis may be. Calcification may be the only evidence of exposure. 290,303 Metastatic pulmonary calcification causes reductions in VC, Dlco, and Pao2, which are directly related to the magnitude and extent of the calcium deposits. Immune deficiency is commonly associated with this syndrome and is frequently severe. However, improvement is not universal or even expedient. Pulmonary calcification in the absence of hypercalcaemia also occurs in the tracheobronchial cartilages of the elderly, the cartilaginous nodules of tracheobronchopathia osteochondroplastica and bronchopulmonary amyloid tumours. (https://www.heart.org/-/media/Files/About-Us/Policy-Research/Policy-Positions/Clinical-Care/Coronary-Artery-Calcium-Screening-2019.pdf). This is called a coronary artery calcium (CAC) test, which looks at: Your healthcare provider will multiply your calcification area by its density to get an Agatston score. Sometimes surgery is needed to remove the pleura. In some patients, atresias cannot be detected; rather, severe colitis with characteristic features of mucosal atrophy and massive enterocyte apoptosis is present.32 The prognosis of this condition is poor. 1-51). How severe is my coronary artery calcification? Use for phrases Yes, a lung nodule can be cancerous. WebIntrathoracic calcification is an important feature of pulmonary disease (Box 1-10). Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. By continuing you agree to the use of cookies. Use to remove results with certain terms Amorphous, punctate, and reticular patterns of calcification have been described in lung cancer. The link you have selected will take you to a third-party website. People who are white are more likely than other races to have coronary artery calcification. Coronary artery calcification: pathogenesis and prognostic implications. The pathogenesis of lung calcification and ossification is not well understood. Brown K, Mund DF, Aberle DR, Batra P, Young DA. This topic is discussed in more detail in Chapter 11. Learn more about the Merck Manuals and our commitment to Global Medical Knowledge. Typically, resolution of hypoxemia from HPS occurs over the initial 8 months following transplant.172. All rights reserved. These studies found that most cases of histoplasmosis occur in the central section of the United States. They're very common. WebA lung (pulmonary) nodule is an abnormal growth that forms in a lung. WebAtelectasis is one of the most common breathing (respiratory) complications after surgery. This makes it difficult for blood to get through your arteries. Intrathoracic calcification is an important feature of pulmonary disease (Box 1-10). Current understanding of coronary artery calcification. Radiographics : a review publication of the Radiological Society of North America, Inc. 14 (6): 1247-61. It is most common in patients with chronic renal disease who are maintained on dialysis and have secondary hyperparathyroidism. Exposure to asbestos can lead to focal, plaquelike pleural fibrosis, at times with calcification, occurring up to 20 years after the initial exposure. Sometimes branching spicules of bone extend through the lung in a racemose or dendriform manner.178183 Isolated foci of laminated bone may also be found within alveoli of otherwise normal appearance (see Fig. 1-ranked heart program in the United States. The basics of intravascular optical coherence tomography. Lamellar bone, readily recognisable as such, is laid down, and marrow spaces are often evident. Check for errors and try again. It is usually dystrophic (i.e., occurs in areas of necrosis). The diagnosis of metastatic calcification can usually be made based on a clinical history of chronic renal failure; lack of significant respiratory symptoms; and characteristic appearance of fluffy, poorly defined, 3- to 10-mm-diameter, upper lobe nodules on high-resolution CT and by demonstration of calcification on CT or 99mTc-MDP scintigraphy. Pleural inflammation commonly causes acute pleural thickening due to fibrosis. Providers have found the CAC test accurately predicts future cardiovascular risk. Use OR to account for alternate terms Dystrophic calcification is very common in pulmonary scars, particularly those resulting from tuberculosis, chickenpox and histoplasmosis. Calcification may be the only evidence of exposure. Combined gut and bone marrow transplantation could be attempted. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Risk factors Diagnosis Treatment Outlook Summary A calcified granuloma in the lung is a cluster of immune cells with calcium deposits. When a larger area is affected, people may have difficulty breathing because the fibrosis prevents the lungs from expanding. Bendayan D, Barziv Y, Kramer MR. If the disorder is mild and only small parts of the pleura are affected, treatment may not be needed. People who have coronary heart disease usually have coronary artery calcification. A type of imaging called computed tomography or multidetector computed tomography (MDCT) can find coronary atherosclerosis before it becomes advanced. Floudas CS, Kanakis MA, Andreopoulos A et-al. Diffuse pulmonary calcification can occur in a number of entities (Fig. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712374/). (2010) Annals of thoracic medicine. Pericarditis is a potentially devastating complication in systemic sclerosis. Before menopause, estrogen protects women from developing atherosclerosis. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. In most cases, the thickening resolves almost completely once the inflammation resolves. Metastatic pulmonary calcification may occur with long-standing hypercalcemia. What treatment do you recommend for my specific situation? Less commonly, it is metastatic (i.e., Calcification makes it difficult for your healthcare provider to do percutaneous coronary intervention (PCI) or angioplasty. Use OR to account for alternate terms pulmonary amyloidosis; metastatic pulmonary calcifications Calcified pulmonary nodules are a subset of hyperdense pulmonary nodules and a group of nodules with a relatively narrow differential. Reference article, Radiopaedia.org (Accessed on 28 Jun 2023) https://doi.org/10.53347/rID-52343. Please confirm that you are not located inside the Russian Federation. The amount of calcification you have is an indicator of how bad your atherosclerosis may be. Cultures of specimens of bone marrow and blood from an autopsy performed soon after the patients death revealed a fungus, Histoplasma capsulatum. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. 45 (1): 124-8. At that point, however, the history of histoplasmosis shifted to the center of the United States, where histoplasmosis is now recognized to be common. In the presence of a depressed immune system, as occurs with HIV infection, corticosteroid therapy or organ transplantation, progressive disseminated histoplasmosis may occur.8,9,12 In some of the endemic areas of the country, histoplasmosis is the opportunistic infection that most frequently leads to a diagnosis of AIDS. Metastatic calcification usually occurs in the apical and subapical lung zones, but it may be diffuse. Uremic pneumonopathy (pneumonitis) is one of the many extrarenal lesions seen in dogs with chronic uremia. Roleder T, Jkaa J, Kaua GL, et al. This strain, known as the H. duboisii form or large-form African histoplasmosis, is considered to be a variety of H. capsulatum; a similar pattern of illness is seen in this African histoplasmosis form.9,10.
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