Dystrophic calcification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dystrophic Calcification (D.C.) is the mineralization of soft tissue without a systemic mineral imbalance. A systemic imbalance would elevate calcium levels in the blood and all tissues: metastatic calcification. This occurs as a reaction to tissue damage, including as a consequence of medical device implantation.

Dystrophic calcification can occur in a eucalcemic state. Basophilic calcium salt deposits aggregate, first in the mitochondria, and progressively throughout the cell. These calcifications are an indication of previous cell injury on the microscopic level.

Calcification can occur in dead or degenerated tissue

Calcification in dead tissue

Caseous necrosis in T.B. is most common site of dystrophic calcification.
Liquefactive necrosis in chronic abscesses may get calcified.
Fat necrosis following acute pancreatitis or traumatic fat necrosis in breasts results in deposition of calcium soaps.
Infarcts may undergo D.C.
Thrombi, esp. in veins, may produce phleoboliths.
Haematomas in the vicinity of bones may undergo D.C.
Dead parasites like schistostoma eggs show D.C.
Congenital toxoplasmosis involving CNS visualised by calcification in infaract brain.

Calcification in degenerated tissue

Dense scars may undergo hyaline degeneration and calcification.
Atheroma in aorta and coronaries frequently undergo calcification.
Cysts can show calcifcation.
Calcinosis cutis is condition in which there are irregular nodular deposits of calcium salts in skin and subcutaneous tissue.
Senile degenerative changes may be accompanied by calcification.

Pathological Findings

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Metastatic calcification is only one of two forms of pathologic calcification. Unlike metastatic calcification, dystrophic calcification does not require an increase in serum calcium levels. This is a gross specimen of a heart with dystrophic calcification of the aortic valve (arrow).
A closer view of this same aortic valve (arrow) illustrates the nodularity and thickening of this valve. This valve would be extremely stiff and almost entirely immobile. This particular example of dystrophic calcification is associated with a degenerative change of the aortic valve due to an unknown cause.
This gross photograph affords a closer view of the same aortic valve. Note the nodularity and thickening of this valve due to fibrosis and dystrophic calcification.