Mottled Areas of Intra-abdominal Calcification

Dr. Robert J. Cihak: This case is being presented for discussion of the roentgenograms without benefit of a clinical history, except that the patient is a 60-year-old man. Discussion Dr. Laurence L. Robbins: Here is a challenge for you, Dr. Janower. Dr. Murray L. Janower: The posteroanterior and lateral views of the chest reveal evidence of chronic lung disease and a remote fracture of the left clavicle. There are mottled punctuate calcifications in the upper portion of the abdomen varying in size from pin-head to about 7 mm (Fig 1). The calcifications are most prominent in the right upper quadrant but do extend across the midline at the level of the second lumbar vertebral body. The spleen and retroperitoneal structures are normal. The lateral view of the abdomen shows the calcifications to be farther anteriorly than one would expect for renal, adrenal, or, more likely, pancreatic calcification. The rest of