Utilization of Faxitron^TM imaging for the pathologic diagnosis of calciphylaxis: A case report

Introduction: Calciphylaxis is a rare, life-threatening condition characterized by vascular calcification, thrombosis, and ischemic necrosis of the skin and subcutaneous tissues. Diagnosing calciphylaxis can be challenging due to non-specific clinical features and limitations of conventional biopsy techniques. Case Report: We describe a 62-year-old female with a history of hypertension, type 2 diabetes mellitus, and sarcoidosis, presenting with painful necrotic abdominal lesions. Initial punch biopsy revealed non-specific changes without evidence of calciphylaxis. During surgical debridement, calcified vessels were observed intraoperatively. FaxitronTM imaging of excised tissue confirmed vascular calcifications, guiding targeted histopathological analysis. Subsequent examination demonstrated medial calcification, intimal hyperplasia, and vascular occlusion, confirming calciphylaxis. Conclusion: This case highlights the utility of FaxitronTM imaging in enhancing the diagnostic accuracy of calciphylaxis. By guiding targeted histological evaluation, this imaging modality can minimize false negatives and facilitate early, accurate diagnosis, improving patient outcomes.