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
Pathology
Causes includeAetiology
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: 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>- +<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 <strong>Jacobsen and Felson</strong> 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>
-</ul><h5>Causes include</h5><p>In the mediastinum and thorax</p><ul>- +</ul><h4>Pathology</h4><h5>Aetiology</h5><p>In the mediastinum and thorax</p><ul>
-<a href="/articles/silicosis">silicosis</a> - 5% patients</li>- +<a href="/articles/silicosis">silicosis</a>: 5% patients</li>
-<a href="/articles/coal-workers-pneumoconiosis-2">coal workers' pneumoconiosis (CWP)</a> - 1% patients</li>- +<a href="/articles/coal-workers-pneumoconiosis-2">coal workers' pneumoconiosis (CWP)</a>: 1% patients</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>- +<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>
-<a href="/articles/amyloidosis">amyloidosis</a> - rare</li>- +<a href="/articles/amyloidosis">amyloidosis</a>: rare</li>
-<a href="/articles/blastomycosis">blastomycosis</a> (e.g. <a href="/articles/pulmonary-blastomycosis">pulmonary blastomycosis</a>) - rare </li>- +<a href="/articles/blastomycosis">blastomycosis</a> (e.g. <a href="/articles/pulmonary-blastomycosis">pulmonary blastomycosis</a>): rare </li>
-<a href="/articles/histoplasmosis">histoplasmosis</a> (e.g. <a href="/articles/thoracic-histoplasmosis-1">pulmonary histoplasmosis</a>) - rare</li>- +<a href="/articles/histoplasmosis">histoplasmosis</a> (e.g. <a href="/articles/thoracic-histoplasmosis-1">pulmonary histoplasmosis</a>): rare</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>- +<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>
-<a href="/articles/assessment-of-thyroid-lesions">thyroid tumours</a> and <a href="/articles/multinodular-goiter">multinodular goitre</a>- +<a href="/articles/assessment-of-thyroid-lesions-general">thyroid tumours</a> and <a href="/articles/multinodular-goiter">multinodular goitre</a>
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Case 21: from calcified oil cyst
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