Calciphylaxis: Comparison of radiologic imaging and histopathology

Background The current gold standard for diagnosis of calciphylaxis is a skin biopsy specimen demonstrating calcification of small-caliber arteries or arterioles. Objective The aim of this study is to compare diameters of calcified vessels seen in skin biopsy specimens and radiology images of patients with calciphylaxis. Methods We conducted a retrospective study of patients with known calciphylaxis from 2009 to 2016 at a community hospital who had both skin biopsy specimens and radiology images taken as part of their routine care. Vascular calcification was compared in skin biopsy specimens and radiology images. Results Seven patients were identified. Small-vessel calcification as fine as 0.1 to 0.3 mm was identified on plain films in 3 patients; 0.1 to 0.2 mm by mammography in 3 patients, and 0.1 to 0.2 mm by computed tomography imaging in 1 patient, nearly as fine a resolution as on histopathology. Limitations This was a single-center study with limited sample size. Conclusion Radiologic imaging might enable more rapid diagnosis of calciphylaxis when skin biopsy specimen is pending or not available.