Case Report
Diffuse Pulmonary Ossification Associated With Idiopathic Pulmonary Fibrosis
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"apellidos" => "Fernández Crisosto" "email" => array:1 [ 0 => "cafedoc007@tutopia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "O." "apellidos" => "Quercia Arias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "N." "apellidos" => "Bustamante" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "H." "apellidos" => "Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Uribe Echevarría" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía de Tórax y Cardiovascular, Hospital de Córdoba, Córdoba, Argentina" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumonología, Hospital de Córdoba, Córdoba, Argentina" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. C.A. Fernández Crisosto. Avda. Patria, 656. X5004AAP Córdoba. Argentina" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-12-13" "fechaAceptado" => "2004-03-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153232" "palabras" => array:3 [ 0 => "Dendriform pulmonary ossification" 1 => "Idiopathic pulmonary fibrosis" 2 => "Lung biopsy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153231" "palabras" => array:3 [ 0 => "Osificación pulmonar dendriforme" 1 => "Fibrosis pulmonar idiopática" 2 => "Biopsia pulmonar" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Diffuse pulmonary ossification is a rare entity that presents with the formation of mature bone in the pulmonary parenchyma and is associated with diffuse and chronic lung disease, heart disease, or other system disorders. Diffuse pulmonary ossification is usually a postmortem finding by the pathologist. In the case we report, the diagnosis was established by open lung biopsy. The patient was a 79-year-old man with dyspnea, dry cough, and weight loss. He had been a smoker. A chest x-ray revealed reticulonodular bilateral pulmonary infiltrates. Computed tomography revealed interstitial disease predominantly in the septum with multiple cavitations that tended to form honeycomb patterns. Pleural thickening, retraction of the parenchyma, and bilateral fibrosis were also visible. A clinical diagnosis of interstitial fibrosis was established and the patient's course was unfavorable. An open lung biopsy was performed. The lung tissue specimens revealed zones with collapsed alveoli and others with emphysema, some of which produced secretion and erythrocytic extravasation. Interstitial vascular congestion was apparent; bronchioles presented mononuclear and some polymorphonuclear inflammatory infiltrates. Noteworthy was the presence of predominantly interstitial, multicentric foci of osseous trabeculae-some of which included adipose bone marrow. Diffuse pulmonary ossification is usually an incidental finding in autopsies of patients with a history of diffuse chronic pulmonary disease, but it is an unusual diagnosis in living patients. Diffuse pulmonary ossification is of no prognostic significance in pulmonary fibrosis. It is a marker of the chronicity and/or severity of the fibrosis.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La osificación pulmonar difusa es una rara entidad que consiste en la formación de hueso maduro en el parénquima pulmonar, asociada a patología pulmonar difusa y crónica, cardíaca o extracardiopulmonar. Esta entidad constituye habitualmente un hallazgo anatomopatológico <span class="elsevierStyleItalic">post mortem.</span> En este caso se realiza el diagnóstico mediante biopsia pulmonar a cielo abierto.</p><p class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un varón de 79 años, con disnea, tos seca y pérdida de peso. Había sido fumador. En la radio-grafía de tórax se apreciaba un infiltrado pulmonar bilateral reticulonodulillar. La tomografía computarizada evidenció afectación intersticial con predominio septal y múltiples ca-vidades con tendencia a la panalización; engrosamiento pleural, retracción del parénquima y fibrosis bilateral. Se estableció el diagnóstico clínico de fibrosis intersticial idiopática, y el paciente evolucionó desfavorablemente. Se reali-zó una biopsia a cielo abierto. La biopsia pulmonar evidenció zonas de colapso alveolar y otras enfisematosas, algunas con secreción y extravasación eritrocitaria. Había vasocongestión intersticial; los bronquiolos presentaban infiltrado inflama-torio mononuclear y algunos polimorfonucleares. Llamaba la atención la presencia de trabéculas óseas, algunas que in-cluían la médula ósea, de tipo adiposo, en focos multicéntri-cos, predominantemente intersticiales.</p><p class="elsevierStyleSimplePara elsevierViewall">La osificación pulmonar difusa constituye habitualmente un hallazgo incidental en autopsias de pacientes con antece-dentes de enfermedad pulmonar crónica difusa, siendo inu-sual el diagnóstico en un paciente vivo. La osificación pulmonar difusa no posee significación pronóstica en la fibrosis pulmonar. Constituye un signo de cronicidad y gravedad de la enfermedad.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calcium deposition with or without bone formation in the lung" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Chan ED" 1 => "Morales DV" 2 => "Welsh CH" 3 => "McDermott MT" 4 => "Schwarz MI" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2002" "volumen" => "165" "paginaInicial" => "1654" "paginaFinal" => "1669" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic pulmonary ossification" "autores" => 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 3 | 6 |
| 2024 October | 32 | 16 | 48 |
| 2024 September | 30 | 16 | 46 |
| 2024 August | 42 | 36 | 78 |
| 2024 July | 29 | 21 | 50 |
| 2024 June | 43 | 24 | 67 |
| 2024 May | 36 | 36 | 72 |
| 2024 April | 23 | 21 | 44 |
| 2024 March | 19 | 20 | 39 |
| 2024 February | 25 | 21 | 46 |
| 2023 March | 3 | 0 | 3 |
| 2023 February | 17 | 20 | 37 |
| 2023 January | 18 | 22 | 40 |
| 2022 December | 22 | 48 | 70 |
| 2022 November | 16 | 20 | 36 |
| 2022 October | 20 | 28 | 48 |
| 2022 September | 12 | 27 | 39 |
| 2022 August | 19 | 32 | 51 |
| 2022 July | 20 | 33 | 53 |
| 2022 June | 15 | 26 | 41 |
| 2022 May | 12 | 27 | 39 |
| 2022 April | 16 | 24 | 40 |
| 2022 March | 22 | 33 | 55 |
| 2022 February | 21 | 26 | 47 |
| 2022 January | 11 | 32 | 43 |
| 2021 December | 16 | 45 | 61 |
| 2021 November | 22 | 34 | 56 |
| 2021 October | 16 | 49 | 65 |
| 2021 September | 18 | 41 | 59 |
| 2021 August | 17 | 29 | 46 |
| 2021 July | 24 | 27 | 51 |
| 2021 June | 10 | 25 | 35 |
| 2021 May | 17 | 26 | 43 |
| 2021 April | 27 | 52 | 79 |
| 2021 March | 21 | 19 | 40 |
| 2021 February | 12 | 19 | 31 |
| 2021 January | 14 | 19 | 33 |
| 2020 December | 18 | 15 | 33 |
| 2020 November | 8 | 17 | 25 |
| 2020 October | 8 | 18 | 26 |
| 2020 September | 16 | 11 | 27 |
| 2020 August | 34 | 21 | 55 |
| 2020 July | 44 | 22 | 66 |
| 2020 June | 15 | 18 | 33 |
| 2020 May | 36 | 25 | 61 |
| 2020 April | 43 | 16 | 59 |
| 2020 March | 38 | 25 | 63 |
| 2020 February | 61 | 16 | 77 |
| 2020 January | 56 | 23 | 79 |
| 2019 December | 20 | 28 | 48 |
| 2019 November | 7 | 25 | 32 |
| 2019 October | 5 | 19 | 24 |
| 2019 September | 18 | 18 | 36 |
| 2019 August | 9 | 16 | 25 |
| 2019 July | 16 | 24 | 40 |
| 2019 June | 7 | 20 | 27 |
| 2019 May | 9 | 24 | 33 |
| 2019 April | 19 | 53 | 72 |
| 2019 March | 14 | 29 | 43 |
| 2019 February | 19 | 28 | 47 |
| 2019 January | 14 | 16 | 30 |
| 2018 December | 9 | 29 | 38 |
| 2018 November | 12 | 26 | 38 |
| 2018 October | 20 | 25 | 45 |
| 2018 September | 16 | 23 | 39 |
| 2018 May | 6 | 4 | 10 |
| 2018 April | 4 | 30 | 34 |
| 2018 March | 4 | 18 | 22 |
| 2018 February | 9 | 23 | 32 |
| 2018 January | 6 | 15 | 21 |
| 2017 December | 4 | 14 | 18 |
| 2017 November | 4 | 20 | 24 |
| 2017 October | 12 | 20 | 32 |
| 2017 September | 3 | 18 | 21 |
| 2017 August | 5 | 16 | 21 |
| 2017 July | 2 | 15 | 17 |
| 2017 June | 10 | 54 | 64 |
| 2017 May | 8 | 22 | 30 |
| 2017 April | 2 | 15 | 17 |
| 2017 March | 1 | 54 | 55 |
| 2017 February | 0 | 29 | 29 |
| 2017 January | 1 | 11 | 12 |
| 2016 December | 12 | 14 | 26 |
| 2016 November | 13 | 9 | 22 |
| 2016 October | 9 | 17 | 26 |
| 2016 September | 14 | 18 | 32 |
| 2016 August | 10 | 8 | 18 |
| 2016 July | 9 | 10 | 19 |
| 2016 June | 2 | 0 | 2 |
| 2016 May | 2 | 0 | 2 |
| 2016 April | 3 | 0 | 3 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 4 | 0 | 4 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 177 | 1 | 178 |
| 2015 September | 175 | 23 | 198 |
| 2015 August | 173 | 21 | 194 |
| 2015 July | 209 | 16 | 225 |
| 2015 June | 190 | 35 | 225 |
| 2015 May | 199 | 22 | 221 |
| 2015 April | 142 | 22 | 164 |
| 2015 March | 157 | 24 | 181 |
| 2015 February | 137 | 16 | 153 |
| 2015 January | 161 | 22 | 183 |
| 2014 December | 159 | 22 | 181 |
| 2014 November | 165 | 19 | 184 |
| 2014 October | 206 | 21 | 227 |
| 2014 September | 161 | 16 | 177 |
| 2014 August | 158 | 20 | 178 |
| 2014 July | 145 | 11 | 156 |
| 2014 June | 165 | 19 | 184 |
| 2014 May | 179 | 16 | 195 |
| 2014 April | 166 | 13 | 179 |
| 2014 March | 153 | 16 | 169 |
| 2014 February | 157 | 28 | 185 |
| 2014 January | 112 | 14 | 126 |
| 2013 December | 97 | 17 | 114 |
| 2013 November | 77 | 12 | 89 |
| 2013 October | 83 | 14 | 97 |
| 2013 September | 83 | 26 | 109 |
| 2013 August | 67 | 22 | 89 |
| 2013 July | 68 | 20 | 88 |
| 2013 June | 60 | 11 | 71 |
| 2013 May | 65 | 7 | 72 |
| 2013 April | 56 | 8 | 64 |
| 2013 March | 23 | 5 | 28 |
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