A 55-year-old man who was on renal dialysis was admitted to the hospital for evaluation of nausea and vomiting. A gastric biopsy was performed. The gastric mucosa contained foci of amorphous, bluish (basophilic) material forming aggregates 10-20 mm in diameter. These aggregates were seen mostly in the stroma between the foveolar cells. No other abnormalities were seen, and the pathologist concluded that these changes represent evidence of

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Bluish material in the stroma of the stomach represents foci of calcification. In patients who have chronic renal disease, such calcifications occur in the stomach, the lungs, or the kidneys, and are classified as metastatic. Metastatic calcifications occur in patients who have hypercalcemia, which in this patient was most likely caused by secondary hyperparathyroidism.

A 55-Year-Old Man Who Was on Renal Dialysis Was Admitted