Tree bark like calcification in chest X-ray is seen in -
Syphilitic aortitis, an inflammatory aortitis involving the ascending aorta, sinuses of Valsalva and the aortic valve, is observed most commonly in patients older than 50 years.
Syphilitic aortitis is associated with aortic insufficiency, ascending aortic aneurysms, and a positive serologic test for syphilis. In these patients, angina resulting from occlusion of the ostia of the coronary vessels also can be present.
Calcification occurs in a linear pattern along the ascending aorta
On gross specimen examination, the aorta has been described as revealing a “tree-bark” appearance
Syphilitic aneurysm
Aortoarteritis
Neurofibromatosis
Atherosclerosis