Abnormal calcifications in the urinary tract

A wide variety of calcifications may develop in the urinary tract. Calculi, the most common form of urinary tract calcification, are usually radiopaque due to their calcium content, whereas cystine stones tend to be less opaque. In cortical nephrocalcinosis, calcification may be spotty or may appear as a thin rim outlining the cortex. Intracystic calcification is usually thin and peripheral and is often described as having an "eggshell" appearance. In renal masses, pure central calcification usually indicates malignancy, although malignancy may also be present with pure peripheral calcification. An incomplete ring of calcification seen over the central portion of the kidney should suggest the presence of an abnormal vascular structure. A sloughed papilla may lead to calcification that is usually triangular or ring-shaped or has a broken rim pattern. Ureteral calculi usually have a uniform radiopacity, whereas phleboliths are often less opaque centrally. Like renal calculi, bladder calculi usually contain a calcium component; they may be laminated, faceted, spiculated, or seedlike in appearance. Urachal carcinoma is commonly associated with tumor calcification, which typically occurs at the dome of the bladder. Schistosomiasis of the bladder may produce mural calcification with a typical thin arcuate pattern and may be associated with calcification in other portions of the urinary tract. Although urinary tract calcifications may be difficult to characterize specifically, they can be classified according to location, appearance, and relation to various pathologic conditions.