Pulmonary calcification or…?

Abstract

Citation:Santiapillai J, Kannan S, Tan SL. Pulmonary calcification or…? Anaesth Pain & Intensive Care 2014;18(3):318-19

The presence of diffuse pulmonary calcific lesions in a critically ill patient with respiratory difficulties raises suspicion of potentially serious underlying conditions. However, this need not always be the case.

A 62 year old male was admitted to intensive care with worsening dyspnoea and progressive hypoxia. He had had nasopharyngeal carcinoma 10 years back and had received radiotherapy, which led to pharyngeal damage, swallowing difficulty and recurrent aspirations requiring a percutaneous gastrostomy feeding tube. Provisional diagnosis was pneumonia secondary to aspiration and infection. In addition to changes suggestive of pneumonia, the chest x-ray also showed dense, speckled calcified opacities within the lower zones bilaterally (Figure 1). The opacities were caused by residual barium from aspiration after an oral contrast study done over a year ago.