Diffuse pulmonary ossification in a patient exposed to silica

To the Editor:

Pulmonary ossification is a rare disease characterised by the formation of diffuse small fragments of mature bone tissue in the lungs. It can be idiopathic or associated with underlying chronic lung, heart or systemic disorders. We present the case of an 83-year-old male, who had diffuse dendriform pulmonary ossification (DPO) and a spontaneous pneumothorax.

An 83-year-old male nonsmoker with a history of hypertension and carotid and coronary angioplasties visited his medical practitioner for right chest pain after a flight from Spain to France. He had no history of lung disease or heart failure.

He worked as a dentist with a dental prosthesis manufacturer. Our patient was frequently in the same workshop as the prostheses technician.

The patient had no trauma, cough, sputum disorders or dyspnoea. A physical examination and the usual biological analyses were normal, particularly the phosphocalcic values.

Chest radiography revealed a partial right pneumothorax with micronodular calcified opacities in both lungs. Computed tomography revealed the presence of bilateral disseminated micronodular opacities of calcified densities, predominantly located in the lower lung, which had lower densities than silicosis. There were no calcified lymph nodes in the mediastinum (figs 1 and 2).