Abstract
We report herein the rare case of a patient with dendriform pulmonary ossification (DPO) who developed spontaneous pneumothorax. A 33-year-old male with a history of bronchial asthma presented with pneumothorax of the left lung. An intraoperative inspection revealed no findings of bullae in the entire left lung, but inflammatory pleural changes were identified on the interlobular surface of the left lower lobe. In addition, hard, twig-like configurations were clearly palpable in the subpleural parenchyma and were resected. A histological examination showed acicular bone formations containing myeloid tissue and marrow fat in the lung. DPO was thus diagnosed, and the bony spines were considered to have caused a rupture of the elastic fiber layer of the visceral pleura. DPO may thus have been directly responsible for the pneumothorax in this case.
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References
Chan ED, Morales DV, Welsh CH, McDermott MT, Schwarz MI. Calcium deposition with or without bone formation in the lung. Am J Respir Crit Care Med. 2002;165:1654–69.
Kanne JP, Godwin JD, Takasugi JE, Schmidt RA, Stern EJ. Diffuse pulmonary ossification. J Thorac Imaging. 2004;19:98–102.
Tseung J, Duflou J. Diffuse pulmonary ossification: an uncommon incidental autopsy finding. Pathology. 2006;38:45–8.
Jaderborg JM, Dunton RF. Rare clinical diagnosis of dendriform pulmonary ossification. Ann Thorac Surg. 2001;71:2009–11.
Lara JF, Catroppo JF, Kim DU, da Costa D. Dendriform pulmonary ossification, a form of diffuse pulmonary ossification: report of a 26-year autopsy experience. Arch Pathol Lab Med. 2005;129:348–53.
Shi X, Zhang W, Nabieu PF, Zhao W, Fu C. Early postoperative heterotopic omental ossification: report of a case. Surg Today. 2011;41:137–40.
Ekholdt PF, Oppedal BR, Arva P. Diffuse pulmonary ossification and spontaneous pneumothorax in a pilot: a case report. Aviat Space Environ Med. 1986;57:696–8.
Ikeda Y, Yamashita H, Tamura T. Diffuse pulmonary ossification and recurrent spontaneous pneumothorax in a patient with bronchial asthma. Respir Med. 1998;92:887–9.
Joines RW, Roggli VL. Dendriform pulmonary ossification. Report of two cases with unique findings. Am J Clin Pathol. 1989;91:398–402.
Ryan CF, Flint JD, Muller NL. Idiopathic diffuse pulmonary ossification. Thorax. 2004;59:1004.
Kobayashi S, Hara M, Yano M, Tateyama H, Shibamoto Y. Dendriform pulmonary ossification in a patient with a past history of giant cell tumor in femur. J Thorac Imaging. 2008;23:47–9.
Wilson WR, Sasaki R, Johnson CA. Disseminated nodular pulmonary ossification in patients with mitral stenosis. Circulation. 1959;19:323–31.
Tsuji T, Nakamura S, Komuro I, Mikami M, Baba M, Tanaka M. A living case of pulmonary ossification associated with osteoclast formation from alveolar macrophage in the presence of T-cell cytokines. Intern Med. 2003;42:834–8.
Lushka H. Verastigte knochenbildung im parenchym der lung. Virchows Arch. 1856;10:500–5.
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Tatsuya Kato and co-authors have no conflicts of interest to declare.
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Kato, T., Ishikawa, K., Kadoya, M. et al. Spontaneous pneumothorax in a patient with dendriform pulmonary ossification: report of a case. Surg Today 42, 903–908 (2012). https://doi.org/10.1007/s00595-012-0136-6
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DOI: https://doi.org/10.1007/s00595-012-0136-6