The constellation of neuropathologic features (ventriculomegaly, mineralized neurons, and dystrophic calcification
with band-like subcortical distribution) differs from features seen in other common infections associated with congenital abnormalities (e.g., TORCH [toxoplasmosis, other viruses, rubella, cytomegalovirus and herpesvirus infections]) and should raise suspicion for congenital Zika virus infection, warranting further workup.
Key Words: Calcinosis cutis, Dystrophic calcification
The wall was thick and fibrotic with focal dystrophic calcification
and aggregates of lymphocytes.
Calcium hydroxide - once considered the standard for pulp-capping material - provides an option for reparative dentin formation, but long term studies have shown results were variable and somewhat unpredictable.4 The material does not provide close adaptation to dentin, does not promote consistent odontoblast differentiation and has been shown to be cytotoxic in cell cultures; the resultant reparative dentin formation can be characterized by tunnel defects.6,7 Tunnel defects within dentin bridges may provide a pathway for the penetration of microorganisms to activate circulating immune cells, induce pulpal irritation and produce subsequent dystrophic calcification
Microscopically, the lesion is well-circumscribed, mostly encapsulated, and has a uniform appearance of extensive, dense hyalinization and sclerosis of fibrocollagenous tissue (Figure, B) with dystrophic calcification
Metaplasia of the connective tissue leads to dystrophic calcification
and bone formation.
Paraffin sections confirmed the diagnosis and showed prominent vessels, perivascular pseudorosettes and areas of dystrophic calcification
. On immunohistochemical staining, the tumour was strongly positive for vimentin, GFAP and EMA.
The necrosed areas at times contained foci of dystrophic calcification
and cholesterol clefts (Figure 8).
Intracellular and extracellular deposits of ochronotic pigment suggested it could function as a stimulus for dystrophic calcification
. Light microscopy observation showed various degrees of pathological alterations and severe calcification involving surface endothelium, underlying basement membranes, and deeper layers of interweaving networks of collagen fiber bundles in the pars fibrosa of the valve tissues as well as cellular swelling indicative of degenerative lesions (Figure 1(b)).
Flecks of dystrophic calcification
are common, and iron deposition can be easily demonstrated with the use of special stains (Piccin et al.).
Histopathology revealed a mostly reactive stroma with fibrosis, dystrophic calcification
, evidence of previous hemorrhage, and areas of admixed mature adipocytes.
Histological evaluation demonstrated granulation tissue with focal necrosis and dystrophic calcification
, multinucleated giant cells, old hemorrhagic products, reactive histiocytosis at the periphery, and rare black angulated metallic fragments (Fig.
Histopathologically, thick membranous specimen of 6.5x2.5x0.5 cm weighing 14 cc was examined to reveal necrotic tissues, dystrophic calcification
and epithelial cyst wall suggestive of hydatidosis.