A 60-year-old woman with long-standing primary hyperparathyroidism undergoes gastrectomy. Histology of the gastric mucosa shows basophilic granular deposits within parietal cell cytoplasm, confirmed to be calcium salts. Which statement best distinguishes this process from calcification occurring in a remote myocardial infarct scar?

• A It occurs in dead tissue while infarct calcification occurs in living tissue
• B It involves iron salt deposition while infarct calcification involves calcium
• C It reflects abnormal serum calcium while infarct calcification occurs with normal calcium levels ✓
• D It is always asymptomatic while infarct calcification produces organ dysfunction

Explanation

Calcification in hyperparathyroidism is metastatic calcification, occurring in previously normal tissues because serum calcium (or phosphate) is elevated; it characteristically deposits in acid-secreting gastric mucosa, kidneys, lungs, systemic arteries, and pulmonary veins where local pH changes favor precipitation. Calcification of an old infarct scar is dystrophic calcification, arising locally in dead or damaged tissue with normal serum calcium. Both are calcium phosphate deposition, so the discriminating variable is the serum mineral status.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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