hi may i ask for the possible causes of calcified granuloma at the caudate lobe of liver with concurrent frequent multiple calcification in spleen the patient asymptomatic no history suggesting any past infections his laps shows double fold increase in P.T.H level with normal ionised calcium level and alkaline phosphatase and normal other laps no picture of auto immune disease such sarcoidosis normal tumour markers and ESR and normal LFS&RFS the only significant history is recurrent renal stones i asked him finally to do cyst amibi scan parathyroid and s.phosphorous is there are any other possibilities such parasitic infections and how can i deal with this patient many thanks for your kindeness