Pathologic Calcification Flashcards
Pathologic calcification
Abnormal deposition of _______ in tissues.
Smaller amounts of __,___ other minerals may also be present.
calcium salt
Mg, Fe,
Pathologic calcification
● 2 types:
○_______ calcification
○________ calcification
Metastatic
Dystrophic
Dystrophic
●______ tissues
●____ Ca levels
●________ in Ca metabolism
Dying
Normal
No derangement
Metastatic
•_____ tissue
●____ Ca levels
●_______ in Ca
metabolism
Normal
High
Derangement
Dystrophic calcification - Pathogenesis
● Found in ______ tissue regardless of ___
● The ________ in degenerate or necrotic tissue bind ______ ions and then react with _____ ions to form precipitates of _____
necrotic; type
denatured proteins
phosphate; calcium
calcium phosphate
Dystrophic calcification
The final common pathway is the formation of _______ as an ____ which is similar to the ______ of _____
calcium phosphate mineral
Apatite; hydroxyapatite of bone.
Dystrophic calcification
● _________ causes the accumulation of calcium in membrane bound vesicles.
● The calcium deposit attracts the deposition of _____
Membrane damage
phosphate
Dystrophic calcification
The cycle of calcium and phosphate deposition continues until a _______ that then propagates and leads to _______
On occasion, a sigle necrotic cell can bind with ____ and then attract layers of mineral deposition and form a _______
microcrystal is formed.
more calcium deposition.
calcium
psammoma body.
Dystrophic calcification
Morphology
● Macroscopically (naked eye), they appear as ___, ____ granules or clumps which are ___ to touch.
fine
white
gritty
Dystrophic calcification
Microscopically, Ca salts look _____ (____), _______ and may have a lamellated appearance.
basophilic; purplish blue
amorphous
Dystrophic calcification is only intracellular
T/F
F
They may be intracellular or extracellular
Metastatic calcification
● Occurs in tissues when there is _____
● Principally affects ______ of gastric mucosa, lungs, kidneys, pulmonary veins and systemic arteries. These sites tend to have an _______ compartment that predisposes them to metastatic calcification
hypercalcemia
interstitial tissues
internal alkaline
hypercalcemia may also accentuate dystrophic calcification.
T/F
T
Aetiology of metastatic calcification
● Hyperparathyroidism:
○________ tumors
○ Secretion of _____
Parathyroid; PTH-rP
Aetiology of metastatic calcification
● Destruction of bone tissue
○ Primary tumours of bone e.g. _____
○ Metastatic cancer to the bone e.g. ____
○ Accelerated bone turnover e.g. ________
○ Prolonged _____
multiple myeloma
breast cancer; Paget’s disease
immobilization
Aetiology of metastatic calcification
Vitamin D related disorders
○ Vit. D _______
○_____ (_______ activate Vit. D precursor)
○_______ syndrome (idiopathic hypercalcemia of infancy) causes abnormal sensitivity to Vit. D.
intoxication
Sarcoidosis; macrophages
Williams
Aetiology of metastatic calcification
● Hyperphosphatemia
○______ failure leads to phosphate retention which causes secondary hyperparathyroidism
○_________ phosphate
Renal
Exogenous
Aetiology of metastatic calcification
Milk-alkali syndrome: ___ supplements taken for e.g.______ together with an _____.
Ca
osteoporosis
antacid
Morphology of metastatic calcification
● Usually there is no loss of function in the organ, however massive deposits in
the _____ and ______ ( ______ ) may result in _______ difficulties and ____ damage.
lungs and kidney
nephrocalcinosis
respiratory; kidney
metastatic calcification is Similar to dystrophic calcification morphologically
T/F
T
Examples of dystrophic calcification
1. In _______ heart valves
2. Uterine ______
3._______ blood vessels
4. Tumours e.g. papillary thyroid carcinoma, papillary serous carcinoma
5. ________
6.________ lymphnodes
7. _______ in the lungs
8._______
aging or damaged
leiomyomas
Damaged; Atherosclerosis
Tuberculous; Asbestosis
Lithopaedion
The following except one are causes of metastatic calcification
Parathyroid adenoma
Rickets
Multiple myeloma
Paget’s disease
Renal failure
Rickets
Heterotopic calcification is the ______________
presence of bone in soft tissue where bone normally does not exist.
Dystrophic Calcification
is almost always present in the _____ of advanced atherosclerosis. It also commonly develops in aging or
damaged ______, further hampering their function
atheromas
heart valves
Calcification can be intracellular, extracellular, or in both locations.
T/F
T
Examples of dystrophic calcification
Calcifications in thickened myometrial vessels (___________).
__________ in some tumors like papillary carcinoma thyroid/ Meningioma/ Papillary renal cell carcinoma/ Papillary serous cystadenoma.
Gamma gandy bodies in congestive _______
__________ in Asbestosis of lung
Monckebergs sclerosis
Psammoma bodies
spleenomegaly
Asbestos bodies
Monckeberg’s arteriosclerosis is a ________ and _______ disease involving the ____ of small and medium-sized muscular arteries.
These vessels become calcified independently of ___.
degenerative and noninflammatory
media
atherosclerosis
Psammoma bodies are formed by ____ deposition of calcium around ____ cell which forms ____ for calcium deposit. The term “psammoma” is derived from greek word “psammos” means _____
concentric
necrotic
seed
sand grain
