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Calciphylaxis: Comparison of radiologic imaging and histopathology
Charles L Halasz1, David P Munger2, Heather Frimmer2
1Department of Dermatology, Columbia University Medical Center, New York, New York; Department of Medicine, Norwalk Hospital, Norwalk, Connecticut.
Background:
The current gold standard for diagnosis of calciphylaxis is a skin biopsy specimen demonstrating calcification of small-caliber arteries or arterioles.
Objective:
The aim of this study is to compare diameters of calcified vessels seen in skin biopsy specimens and radiology images of patients with calciphylaxis.
Methods:
We conducted a retrospective study of patients with known calciphylaxis from 2009 to 2016 at a community hospital who had both skin biopsy specimens and radiology images taken as part of their routine care. Vascular calcification was compared in skin biopsy specimens and radiology images.
Results:
Seven patients were identified. Small-vessel calcification as fine as 0.1 to 0.3 mm was identified on plain films in 3 patients; 0.1 to 0.2 mm by mammography in 3 patients, and 0.1 to 0.2 mm by computed tomography imaging in 1 patient, nearly as fine a resolution as on histopathology.
Limitations:
This was a single-center study with limited sample size.
Conclusion:
Radiologic imaging might enable more rapid diagnosis of calciphylaxis when skin biopsy specimen is pending or not available.
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