Lecture 22: Calcification and Post Mortem changes

Question 1

Calcification is?
Looks like when gross and his to section?
The key processes are?

Answer 1

Mineralisation
gross–> white, gritty, hard
histo–> purple deposits, fractured, sharp edges

2 key processes are?
-dystrophic and metastatic

Question 2

Dystrophic Calcification is?

Answer 2

Dystrophic calcification (DC) is the calcification occurring in degenerated or necrotic tissue, as in hyalinized scars, degenerated foci in leiomyomas, and caseous nodules. This occurs as a reaction to tissue damage,

Dystrophic calcification can occur even if the amount of calcium in the blood is not elevated.

A normocalcaemic condition

Serum total Ca: cca. 2.5 mmol/L
Cellular Ca: 10,000 times less (nmol/L)

Question 3

Look at Dystrophic calcification on slide

4

Answer 3

hypercalcaemia is the presence of abnormally high levels of calcium in the blood;

Question 4

What are some examples of Dystrophic Calcification?

Answer 4

• Fat necrosis - insoluble calcium soaps
• Atheromatous plaques (humans, hypothyroid dogs)
• Degenerate heart valves - functional consequences!
• Caseous granulomas (e.g. tuberculosis) often calcify (detected radiographically)
• Tissue injury - e.g. calcification of scars
• Psammoma bodies - whorls of calcification in some tumours e.g. meningioma

Question 5

Describe the aortic valve on slide 6

Answer 5

Dystrophic Calcification of the aortic valve
Slide 6
A human heart, opened to show the left ventricle and the aortic semilunar valves. The arrow shows thickened, pale, irregular deposits within the valves. This is dystrophic calcification. The valves’ function is likely to be affected in this instance.

Question 6

Describe the his to section on slide 9

Answer 6

dystrophic calcification

This is cardiac muscle, as should be clear by the central nuclei (there is also some lipofuscin pigment). This shows the microscopic appearance of calcification, lower left, as dense, irregular basophilic deposits. This is secondary to heart muscle injury, presumably from an infarct.

Question 7

What is the image on slide 10 of and were else can it be seen?

Answer 7

Myoitis ossificans
Also seen in:
-competition horses
-adductor muscles of soccer players

Question 8

Describe the histo section on slide 12

Answer 8

mammary tumor- calcification.
Again, in this mammary tumour, mineralisation shows as a dense, basophilic, irregular deposit.
Microscopically, this infiltrating ductal carcinoma of breast extends irregularly through the stroma as cords and nests of neoplastic cells with intervening collagen. There is a purplish microcalcification at the lower center right. Neoplastic cells are not as robust or as organized as normal cells and are more likely to undergo necrosis. Dystrophic calcification can occur in these areas.

Question 9

Now tell me some cool shit about Metastatic calcification?
-what pathologies are associated with them?
often affects what?
May be due to?

Answer 9

• assosiated with high blood calcium or metabolic disturbance of calcium metabolism
• osteolytic tumors
• primary hyperpaathyroidism (parathyroid adenoma)
• secondary hyperparathyroid (chronic renal failure)
• hypervitaminosis D- enhances interstitial calcium absorption, and removal of calcium from bone -vit D toxicity
• Often affects alveolar walls (pumice lung), stomach mucosa, kidney, small vascular walls
• May be due to pH gradients at some of these sites

Question 10

Describe the histo section on slide 18

Answer 10

metastatic calcification of the lung
This is the microscopic appearance of mineralised lung. The arrow shows an irregular, almost jagged, fragment of basophilic deposit in the alveolar wall – calcification.
Pathguy:
Here is so-called “metastatic calcification” in the lung of a patient with a very high serum calcium level (hypercalcemia).

Question 11

View the table on chronic renal failure and secondary hyperparathyroidism 1

Answer 11

slide 20 and 21

Question 12

MORE TO GO ON THIS

Answer 12

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