Coarse calcifications: What do they mean?

Coarse calcifications are common imaging findings detected across multiple organs and reflect underlying dystrophic or, less frequently, metastatic processes. They most commonly occur in the setting of chronic inflammation, infection, degeneration, or prior intervention. Coarse calcifications associated with malignant lesions are less frequent and are typically identified with soft-tissue masses showing irregular margins, heterogeneous enhancement, interval growth, or evidence of local or distant invasion. Although most coarse calcifications are associated with benign conditions, their significance varies depending on the affected organ, accompanying imaging features, and clinical context. This article provides a comprehensive review of the pathophysiology, etiologies, and imaging characteristics of coarse calcifications in various organs, including the breast, lung, thyroid, pancreas, liver, spleen, adrenal, kidney, bladder, prostate, uterus, ovary, brain, heart, and vasculature. Recognition of organ-specific patterns is essential for accurate diagnosis, risk stratification, and effective management.