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1. Pathologic Calcification
Rohit Kumar Trivedi
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Introduction& Types

2. Pathologic Calcification
• It is the Deposition/Accumulation of Calcium salts in tissue
other than osteoid* or enamel.
• The deposition may be intracellular, extracellular or at
both the locations.
• There are two types of pathologic calcification:
1. Dystrophic calcification 2.Metastatic Calcification
* Osteoid is a protein mixture secreted by osteoblasts that forms the organic matrix of bone. Bone is formed when osteoid mineralizes.

3. 1. Dystrophic calcification
• Encountered in areas of necrosis.
• It is the deposition of calcium salts in dead or degenerated tissues
• Occurs at normal Calcium metabolism and normal serum calcium
level.
2. Metastatic Calcification
• Occurs in normal tissues.
• Associated with deranged calcium metabolism and hypercalcaemia.
Pathologic Calcification
Types

4. • It is encountered in areas of necrosis, whether they are of
coagulative, caseous, or liquefactive type, and in foci
(place) of enzymatic necrosis of fat.
• Calcification is almost always present in the atheromas* of
advanced atherosclerosis**.
• It also commonly develops in aging or damaged heart valves,
further hampering their function.
Pathologic Calcification
1. Dystrophic calcification
*Atheroma, or atheromatous plaque ("plaque"), is an abnormal accumulation of material in the
inner layer of the wall of an artery
**Atherosclerosis is a disease in which plaque builds up inside arteries.

5. • The calcium salts appear macroscopically as fine, white granules
or clumps, often felt as gritty deposits.
• Dystrophic calcification may simply be a telltale sign of previous
cell injury, it is often a cause of organ dysfunction.
Pathologic Calcification
1. Dystrophic calcification
Dystrophic calcification
of the aortic valve

6. May occur in normal tissues whenever there is hypercalcaemia would
include one of the following two conditions:
1. Excessive mobilization of calcium from the bone.
2. Excessive absorption of calcium from the gut.
These causes are more common and include the following :
1. Hyperparathyroidism which may be primary such as due to
parathyroid adenoma, or secondary such as from parathyroid
hyperpl5sia, chronic renal failure etc.
2. Bony destructive lesions
3. Prolonged immobilisation of a patient results in disuse atrophy of
the bones and hypercalcaemia
Pathologic Calcification
2. Metastatic calcification

7. Less often, excess calcium may be absorbed from the gut causing
hypercalcaemia and metastatic calcification. These causes are as
under:
1. Hypervitaminosis-D results in increased calcium absorption.
2. Milk-alkali syndrome caused by excessive oral intake of
calcium in the form of milk and administration of calcium
carbonate in the treatment of peptic ulcer.
3. Hypercalcaemia of infancy is another condition in which
metastatic calcification may occur.
Sites of Metastatic Calcification
• Metastatic calcification can occur in any normal tissue of the
body but affects the following organs more commonly
- Kidney - Lungs, especially in the alveolar walls
- Stomach - Blood Vessels
- Cornea - Synovium
Pathologic Calcification
2. Metastatic calcification

8. Pathologic Calcification
Difference Between Dystrophic & Metastatic Calcification

9. - References -
Intracellular Accumulations

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