Pulmonary calcification in chronic renal failure: use of diphosphonate scintiscan as a diagnostic tool

A patient with endstage renal failure on maintenance hemodialysis for fifty-five months presented with signs and symptoms of cardiorespiratory failure and chest X-ray evidence of cardiomegaly and persistent bilateral nodular lung densities. A lung scan employing a bone seeking radionuclide, 99 Tc Diphosphonate, revealed active uptake in all areas corresponding to the X-ray densities. It was concluded that these densities represented active calcification. Thus, a diagnosis of pulmonary calcification was established without the need to resort to lung biopsy. It is suggested that bone-seeking radionuclides may be employed effectively to help establish an early diagnosis of pulmonary calcification especially in high risk dialysis patients.