E2178. Spectrum of Calcification in Abdominal Imaging: An Important Key for the Potential Diagnosis
  1. Charanjeet Singh; Yale University
Multiple pathologic processes manifest within the abdomen and pelvis in association with calcifications, which can be benign, premalignant, or malignant. Although calcium deposition in the abdomen can occur secondary to various mechanisms, the most common cause is cellular injury that leads to dystrophic calcifications. We will discuss various common and uncommon calcifications in the abdomen and pelvis, primarily using location to illuminate diagnostic significance.

Educational Goals / Teaching Points
Discuss the common mechanisms of calcification in the abdomen and pelvis. Review the common causes of calcification in the abdomen and pelvis. Recognize how do various types of calcifications can help in diagnosing different conditions in the abdomen and pelvis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Pathophysiology of calcium deposition in the abdomen and pelvis. Different types of calcifications: dystrophic, metastatic, Stasis to flow and tumoral calcification Appearance of calcification on different imaging modalities and quadrant-based localization of calcified density. All organ-based calcifications with case specific examples: Liver-healed granuloma, choledocholithiasis, infection, hemangioma, cyst, adenoma and metastasis. Gallbladder: gallstones and porcelain gallbladder. Pancreas: chronic pancreatitis, and calcified metastasis. Spleen: calcified granuloma, phleboliths, treated lymphoma and metastatic/metastasis. Adrenal glands: Infection, trauma, pheochromocytoma and adrenal cortical carcinoma. Kidneys: nephrocalcinosis, milk of calcium, favors renal transplant, tuberculosis and renal cell carcinoma. Bowel loops: foreign body reaction, fecalith, epiploic appendicitis, appendicolith, carcinoid tumor mucinous carcinoma. Urinary bladder: calculi, cyst or schistosomiasis, tuberculosis, prior radiation, leukoplakia and neoplastic process like TCC and serosal carcinoma. Gynecological organs: leiomyoma calcific endometriosis, phleboliths and mild hydronephrosis diabetes mellitus and leiomyosarcoma. Mesentery-sclerosing mesenteritis, carcinoid; peritoneum-fat necrosis, serious for mucinous metastasis. retroperitoneum-fat necrosis, liposarcoma. Vascular: atherosclerotic changes, diabetes mellitus, thrombus and angiosarcoma. Musculoskeletal: abdominal wall calciphylaxis, injection granuloma, myositis ossificans.

Characterizing calcifications in the abdomen and pelvis using an anatomic localization can be helpful in reaching a diagnosis. The abdominal and pelvic calcifications are commonly dystrophic by mechanism and benign, can also be associated with various premalignant and malignant entities. CT is the best imaging modality for detection, pattern recognition, and assessment of the diagnostic significance of various abdominal and pelvic calcifications.