PMC6942723_01
Axial chest CT images using lung (a), (c) and bone (b), (d) windows show bilateral branching dense nodular opacities (arrows) with mild associated reticulation. Some of the nodule are high in attenuation and almost iso-dense to ribs on bone windows. Axial images using lung widow (e), (f) at the level of lung bases were obtained 5 years apart and show evidence of progression.
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fig1
Review of serial chest CT imaging revealed progressive bilateral sub-pleural and peribronchovascular branching dense opacities suggestive of DPO (Figure 1).
Large area of subpleural diffuse pulmonary ossification revealing lamellar bone with a more complicated pattern and areas of marrow elements including fat (arrowhead). Adjacent areas of cicatricial OP (arrows) are present (Hematoxylin and eosin; 12.5x).
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fig2
He underwent VATS wedge resection of the left upper and lower lobes, which confirmed foci of dendriform ossification consisting of islands of ossifying fibrosis (Figure 2).
Areas of OP (arrow) with adjacent foci of cicatricial OP transitioning to DPO (arrowhead) (Movat stain; 20x).
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fig3
DPO were associated with the OPc and showed transitions from conventional OP to OPc to the DPO (Figure 3). Dendriform pulmonary ossification foci were present in the subpleural region and occasionally adjacent to the visceral pleura (Figure 4).
Focal areas of DPO in the subpleura with areas that appeared to extend through the pleura (arrow) (Hematoxylin and eosin; 40x).
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fig4
DPO were associated with the OPc and showed transitions from conventional OP to OPc to the DPO (Figure 3). Dendriform pulmonary ossification foci were present in the subpleural region and occasionally adjacent to the visceral pleura (Figure 4).