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PATHOLOGIC CALCIFICATION
Pathologic Calcification


Pathologic calcification is the abnormal
deposition of calcium salts with smaller
amounts of i...
Mechanism of Calcification


1)

2)

Calcium deposits in the form of hydroxyapatite
and involves two phases:
Initiation: ...
Types of Pathologic
Calcification


Dystrophic Calcification:





When the deposition occurs in dead or
dying tissues...
Dystrophic Calcification








Dystrophic calcification is encountered in areas of
necrosis of any type.
It is certa...
Dystrophic calcification of the aortic valves
Morphology of Dystrophic calcification
Calcium salts are grossly seen as fine
white granules or clumps, often felt as
grit...
Dystrophic calcification in the wall of the stomach
Sites of Dystrophic Calcification

a)
b)
c)






Necrotic tissue
Caseous necrosis of tubercle
Fat necrosis
Liquefac...
Metastatic Calcification


Metastatic calcification can occur in normal
tissues whenever there is hypercalcemia .
Main Causes:
1.

Increased secretion of parathyroid
hormone

2.

Destruction of bone due to the effects of
accelerated tur...
Morphology of Metastatic
calcification




Metastatic calcification can occur widely
throughout the body but principally...
Effect of Metastatic calcification




Extensive calcifications in the lungs may
produce remarkable radiographs and
resp...
Metastatic calcification in the lung of a patient
with a very high serum calcium level

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Pathologic calcification

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Pathologic calcification

  1. 1. PATHOLOGIC CALCIFICATION
  2. 2. Pathologic Calcification  Pathologic calcification is the abnormal deposition of calcium salts with smaller amounts of iron, magnesium, and other minerals.
  3. 3. Mechanism of Calcification  1) 2) Calcium deposits in the form of hydroxyapatite and involves two phases: Initiation: Initiation of calcium takes place in the matrix vesicles where calcium and phosphate accumulate. Matrix vesicles are extracellular membrane bound vesicles that bud off from other cells Propagation: The second phase involves further growth of hydrpxyapatite
  4. 4. Types of Pathologic Calcification  Dystrophic Calcification:    When the deposition occurs in dead or dying tissues it occurs with normal serum levels of calcium and normal calcium metabolism Metastatic Calcification:   The deposition of calcium salts in normal tissues It almost always reflects some derangement in calcium metabolism and increased levels of calcium (hypercalcemia)
  5. 5. Dystrophic Calcification     Dystrophic calcification is encountered in areas of necrosis of any type. It is certain in the atheromas of advanced atherosclerosis, associated with intimal injury in the aorta and large arteries Although dystrophic calcification may be an incidental finding indicating insignificant past cell injury, it may also be a cause of organ dysfunction. For example,  Dystrophic calcification of the aortic valves is an important cause of aortic stenosis in the elderly
  6. 6. Dystrophic calcification of the aortic valves
  7. 7. Morphology of Dystrophic calcification Calcium salts are grossly seen as fine white granules or clumps, often felt as gritty deposits.  Histologically, calcification appears as intracellular and/or extracellular basophilic deposits.  In time, heterotopic bone may be formed in the focus of calcification. 
  8. 8. Dystrophic calcification in the wall of the stomach
  9. 9. Sites of Dystrophic Calcification  a) b) c)      Necrotic tissue Caseous necrosis of tubercle Fat necrosis Liquefactive necrosis Advanced atheromatous lesion Haematoma Thrombus Infarcts Heart valves e.g. sub-acute infective endocarditis
  10. 10. Metastatic Calcification  Metastatic calcification can occur in normal tissues whenever there is hypercalcemia .
  11. 11. Main Causes: 1. Increased secretion of parathyroid hormone 2. Destruction of bone due to the effects of accelerated turnover (e.g., Paget disease), immobilization, or tumors (multiple myeloma, leukemia, or diffuse skeletal metastases) 3. Vitamin D-related disorders including vitamin D intoxication and sarcoidosis 4. Renal failure, in which phosphate retention leads to secondary hyperparathyroidism .
  12. 12. Morphology of Metastatic calcification   Metastatic calcification can occur widely throughout the body but principally affects the interstitial tissues of the vasculature, kidneys, lungs, and gastric mucosa. The calcium deposits morphologically resemble those described in dystrophic calcification.
  13. 13. Effect of Metastatic calcification   Extensive calcifications in the lungs may produce remarkable radiographs and respiratory deficits Massive deposits in the kidney (nephrocalcinosis) can cause stones & renal damage.
  14. 14. Metastatic calcification in the lung of a patient with a very high serum calcium level 

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