Disseminated nodular pulmonary ossification in patients with mitral stenosis.

IN RECENT YEARS clinicians have had to think of histoplasmosis as well as tuberculosis when confronted with diffuse nodular calcific shadows in the lung parenchyma. Disseminated bone formation in the lung is rare, though a form associated with mitral stenosis has been recognized for many years. It is our purpose to review our experience with 4 eases of disseminated bone formation in mitral stenosis, to review autopsy-proved case reports, and to discuss the controversial (uestioll of pathogenesis. The combination of pulinoiiary ossification and mitral stenosis occurs primarily in young men from 21 to 40 years of age. The predominance of men is remarkable considering the more frequent occurrence of mitral stenosis ill women. Presenting symptoms and major physical signs are merely those accompanying ordinary mitral stenosis. Invariably congestive failure has occurred during the course of the disease. Hemoptysis is an infrequent presenting symptom, although a few patients Radiologic examination shows the characteristic findings of mitral stenosis and many have had severe pulmonary hemorrhage. dense opacities throughout the lung fields.