Images in Clinical Medicine
Pulmonary Alveolar Microlithiasis
N Engl J Med 2003; 348:1555April 17, 2003
- Article
A 28-year-old patient was admitted to the hospital with mild pleuritic chest pain. A posterior–anterior chest radiograph showed bilateral diffuse, nodular (“sandstorm-like”) calcifications in both lungs, predominantly in the middle zones (Panel A). A high-resolution computed tomographic scan demonstrated multiple bilateral diffuse micronodular, calcific, and ground-glass opacities throughout both lungs (Panel B). On transbronchial biopsy, the diagnosis of massive parenchymal and alveolar calcification was confirmed. Abdominal ultrasonography revealed medullary nephrocalcinosis. On the basis of these findings, the diagnosis of pulmonary alveolar microlithiasis with concomitant idiopathic medullary nephrocalcinosis was established. Pulmonary alveolar microlithiasis is a rare and slowly progressive disease; the underlying disturbances in calcium and phosphate homeostasis have not yet been identified. A hallmark of the disease is a striking dissociation between the radiologic findings and the only mild clinical signs and symptoms.
Vincent M. Brandenburg, M.D.
Henning Schubert, M.D.
University Hospital, D-52057 Aachen, Germany- Citing Articles (1)
Citing Articles
1
Andreas Synetos, Christodoulos Stefanadis. (2007) The incidence of pulmonary hypertension in patients with pulmonary alveolar microlithiasis. International Journal of Cardiology 118:1, 132
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