Eggshell calcification (lymph nodes)
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Eggshell calcification refers to fine calcification seen at the periphery of a mass, and usually relates to lymph node calcification.
In 1967 Jacobsen and Felson published criteria to help "avoid over-reading of the incidental circumferential concentrations of calcium and to eliminate confusion with the ring shadows of bronchi on end." These criteria were:
- shell-like calcifications up to 2 mm thick must be present in the peripheral zone of at least two lymph nodes
- the calcifications may be solid or broken
- in at least one of the lymph nodes the ringlike shadow must be complete
- the central part of the lymph node may show additional calcifications
- one of the affected lymph nodes must be at least 1 cm in its greatest diameter
Causes include
In the mediastinum and thorax
- silicosis - 5% patients
- treated lymphoma: (postirradiation Hodgkin disease) usually 1-9 years following treatment
- coal workers' pneumoconiosis (CWP) - 1% patients
- sarcoidosis - calcification is uncommon (only 5% of patients) and occurs late in the disease; only rarely does it have eggshell configuration
- scleroderma
- amyloidosis - rare
- blastomycosis (e.g. pulmonary blastomycosis) - rare
- histoplasmosis (e.g. pulmonary histoplasmosis) - rare
In the breast
Differential diagnosis
For eggshell like calcification appearances in the thorax consider
- aneurysms
- parathyroid tumours
- pulmonary arteries in pulmonary arterial hypertension
- thymic cysts
- thyroid tumours and multinodular goitre
See also
-<p><strong>Eggshell calcification</strong> refers to fine calcification seen at the periphery of a mass, and usually relates to lymph node calcification. </p>-<p>In 1967 Jacobsen and Felson published criteria to help "avoid over-reading of the incidental circumferential concentrations of calcium and to eliminate confusion with the ring shadows of bronchi on end." These criteria were: </p>-<ul>-<li>shell-like calcifications up to 2 mm thick must be present in the peripheral zone of at least two lymph nodes</li>-<li>the calcifications may be solid or broken</li>-<li>in at least one of the lymph nodes the ringlike shadow must be complete</li>-<li>the central part of the lymph node may show additional calcifications</li>-<li>one of the affected lymph nodes must be at least 1 cm in its greatest diameter</li>-</ul><h5>Causes include</h5>-<p>In the mediastinum and thorax</p>-<ul>-<li>-<a href="/articles/silicosis">silicosis</a> - 5% patients </li>-<li>treated <a href="/articles/lymphoma">lymphoma</a>: (postirradiation <a href="/articles/hodgkin-lymphoma">Hodgkin disease</a>) usually 1-9 years following treatment </li>-<li>-<a title="Coal workers' pneumoconiosis" href="/articles/coal_workers'_pneumoconiosis">coal workers' pneumoconiosis (CWP)</a> - 1% patients </li>-<li>-<a href="/articles/sarcoidosis-1">sarcoidosis</a> - calcification is uncommon (only 5% of patients) and occurs late in the disease; only rarely does it have eggshell configuration</li>-<li><a href="/articles/scleroderma">scleroderma</a></li>-<li>-<a href="/articles/amyloidosis">amyloidosis</a> - rare </li>-<li>-<a href="/articles/blastomycosis">blastomycosis</a> (e.g. <a href="/articles/pulmonary-blastomycosis" title="pulmonary blastomycosis">pulmonary blastomycosis</a>) - rare </li>-<li>-<a href="/articles/histoplasmosis">histoplasmosis</a> (e.g. <a href="/articles/thoracic-histoplasmosis-1" title="Pulmonary histoplasmosis">pulmonary histoplasmosis</a>) - rare </li>-</ul><p>In the breast</p>-<ul><li>-<a title="Oil cysts" href="/articles/oil-cyst">oil cysts </a>- in <a title="egg-shell calcification within the breast" href="/articles/egg-shell-calcification-within-the-breast">egg-shell calcification within the breast</a> </li></ul><h4>Differential diagnosis</h4>-<p>For eggshell like calcification appearances in the thorax consider</p>-<ul>-<li>aneurysms</li>-<li><a href="/articles/parathyroid-tumours" title="parathyroid tumours">parathyroid tumours</a></li>-<li>pulmonary arteries in <a href="/articles/pulmonary-hypertension-1">pulmonary arterial hypertension</a> </li>-<li><a href="/articles/thymic-cysts">thymic cysts</a></li>-<li>-<a title="Thyroid neoplasms" href="/articles/assessment-of-thyroid-lesions">thyroid tumours</a> and <a href="/articles/multinodular-goiter">multinodular goitre</a> </li>-</ul><h4>See also</h4>-<ul><li><a title="Differential of calcified mediastinal lymph nodes" href="/articles/differential-diagnosis-of-calcified-mediastinal-lymph-nodes">differential of calcified mediastinal lymph nodes </a></li></ul>- +<p><strong>Eggshell calcification</strong> refers to fine calcification seen at the periphery of a mass, and usually relates to lymph node calcification.</p><p>In 1967 Jacobsen and Felson published criteria to help "avoid over-reading of the incidental circumferential concentrations of calcium and to eliminate confusion with the ring shadows of bronchi on end." These criteria were:</p><ul>
- +<li>shell-like calcifications up to 2 mm thick must be present in the peripheral zone of at least two lymph nodes</li>
- +<li>the calcifications may be solid or broken</li>
- +<li>in at least one of the lymph nodes the ringlike shadow must be complete</li>
- +<li>the central part of the lymph node may show additional calcifications</li>
- +<li>one of the affected lymph nodes must be at least 1 cm in its greatest diameter</li>
- +</ul><h5>Causes include</h5><p>In the mediastinum and thorax</p><ul>
- +<li>
- +<a href="/articles/silicosis">silicosis</a> - 5% patients</li>
- +<li>treated <a href="/articles/lymphoma">lymphoma</a>: (postirradiation <a href="/articles/hodgkin-lymphoma">Hodgkin disease</a>) usually 1-9 years following treatment</li>
- +<li>
- +<a href="/articles/coal-workers-pneumoconiosis-2">coal workers' pneumoconiosis (CWP)</a> - 1% patients</li>
- +<li>
- +<a href="/articles/sarcoidosis-1">sarcoidosis</a> - calcification is uncommon (only 5% of patients) and occurs late in the disease; only rarely does it have eggshell configuration</li>
- +<li><a href="/articles/scleroderma">scleroderma</a></li>
- +<li>
- +<a href="/articles/amyloidosis">amyloidosis</a> - rare</li>
- +<li>
- +<a href="/articles/blastomycosis">blastomycosis</a> (e.g. <a href="/articles/pulmonary-blastomycosis">pulmonary blastomycosis</a>) - rare </li>
- +<li>
- +<a href="/articles/histoplasmosis">histoplasmosis</a> (e.g. <a href="/articles/thoracic-histoplasmosis-1">pulmonary histoplasmosis</a>) - rare</li>
- +</ul><p>In the breast</p><ul><li>
- +<a href="/articles/oil-cyst">oil cysts </a>- in <a href="/articles/egg-shell-calcification-within-the-breast">egg-shell calcification within the breast</a>
- +</li></ul><h4>Differential diagnosis</h4><p>For eggshell like calcification appearances in the thorax consider</p><ul>
- +<li>aneurysms</li>
- +<li><a href="/articles/parathyroid-tumours">parathyroid tumours</a></li>
- +<li>pulmonary arteries in <a href="/articles/pulmonary-hypertension-1">pulmonary arterial hypertension</a>
- +</li>
- +<li><a href="/articles/thymic-cysts">thymic cysts</a></li>
- +<li>
- +<a href="/articles/assessment-of-thyroid-lesions">thyroid tumours</a> and <a href="/articles/multinodular-goiter">multinodular goitre</a>
- +</li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/differential-diagnosis-of-calcified-mediastinal-lymph-nodes">differential of calcified mediastinal lymph nodes </a></li></ul>
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Case 1 -: with silicosis
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Case 2 -: from calcified oil cyst
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