Radiological Case: Tumoral Calcinosis

Eric M Christiansen, MD; Shane Mallon, MD; Michelle M; Alan Pitt, MD; Jeremy Hughes, MD


Appl Radiol. 2021;50(3):53-55. 

In This Article

Pathologic Findings

Pathology demonstrated extensive amorphous and granular appearing calcifications in the soft tissue. The smear preparations showed tiny, mixed amorphous calcium crystals, which aggregated into groups and lacked the typical needle or rhomboid shapes of monosodium urate (gout) or calcium pyrophosphate (pseudogout) crystals.

The fixed tissue sections displayed multiple lobules of granular calcifications within the soft tissue, separated by fibrous septa. Rare areas had more active lesions containing macrophages, occasional osteoclast-like multinucleated giant cells, and mild chronic inflammation at the periphery of the lobules. However, most appeared inactive, with only central small, granular and larger, dense psammomatous-like calcifications within fibrous septa (Figure 3).

Figure 3.

Histopathologic features of resected upper cervical paraspinal soft tissue consist of extensive, small, granular and somewhat amorphous calcifications, aggregating into clusters of various sizes (purple material, black arrowheads, left). Large lobules composed of small and larger dense calcifications (black arrows, right), are separated by interweaving dense fibrous septa (pink tissue, white arrows, central/left). H&E, 120X, Scale=200mm.