Fact-sheet: Pulmonary ossification


Updated on 01/15/2026 at 11:08 AM

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Definition

Rare pulmonary disease characterized by the presence of bone within the pulmonary interstitium and/or alveolar space, either localized and/or disseminated.

It may be:

  • idiopathic
  • secondary and/or associated with usual interstitial pneumonia,
  • pulmonary amyloidosis
  • mitral valve stenosis with pulmonary hypertension
  • Busulfan use
  • gastroesophageal reflux
  • pneumothorax

Clinical features

Patients often asymptomatic

Slow progression

Radiography

Branching dendriform calcifications generally predominating in the lower lung zones

CT

Diffuse pulmonary ossification

  • Calcified branching linear opacities measuring 1 to 4 mm, following the distribution of the distal airways
  • dendriform: mature branching bony spicules generally containing bone marrow, and calcified micronodules with an interstitial distribution (interlobular septa, subpleural, perifissural), predominantly peripheral and basal
  • More common in idiopathic usual interstitial pneumonia than in other fibrosing interstitial lung diseases. At least 10 hyperdense nodules are required for the diagnosis, reportedly found in 30% of patients (Egashira et al, Radiology 2017).

Nodular pulmonary ossification