Pulmonary Alveolar Microlithiasis: Radiologic Findings of Eight Cases in Turkey

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Pul mo nary al ve o lar mic ro lit hi a sis (PAM) is a ra re idi o pat hic di se a se cha rac te ri zed by pre sen ce of dif fu se in nu me rab le mi nu te cal cu li cal led mic ro liths The aim of this re port was to des cri be the ra di og rap hic fin dings of PAM with par ti cu lar at ten ti on to fe a tu res pro vi ded by chest X-ray and high resolution computerized tomography (HRCT). M Ma at te er ri ia al l a an nd d M Me et t h ho od ds s: : We diag no sed thre e in dex ca ses of PAM who ca me from the sa me vil la ge in 1996 . In 2005 we per for med a study inc lu ding 279 re si dents of that vil la ge by using mic ro film scre e ning to de ter mi ne undiagnosed ca ses. Fi ve ad di ti o nal ca ses of PAM we re de tec ted and un der went HRCT. HRCT and chest X-ray ima ges of eight ca ses we re as ses sed spe ci fi cally for pat terns, dis tri bu ti on, and pro fu si on of pul mo nary ab nor ma li ti es. R Re e s su ul lt ts s: : Of eight ca ses, four we re adults and four we re chil dren. Dif fuse typi cal mic ro cal ci fi ca ti ons we re de tec ted in chest X-ray in three ca ses whi le re ti cu lo no du lar pattern was seen in three ca ses and re ti cu lar pat tern in two ca ses. Fi ne mic ro cal ci fi ca ti on, pa rench ymal band and fiss su ral pro mi nen ce we re the most com mon fin dings on HRCT. Small subp le u ral cysts we re de tec ted in five ca ses but only ca se 1 sho wed black ple u ral li ne in chest X-ray. One ca se had small subp le u ral bul la e and bronc hi ec ta tic chan ges in both lo wer lo bes pre do mi nantly in the left lung in HRCT. C Co on nc c l lu u s si i o on n: : Re la ti ves of a pa ti ent with PAM ha ving re ti cu lar or reticulonodular pattern in chest X-ray must be investigated in de ta i l for PAM beca u se it can be the early sta ge of the di se a se. HRCT has a ma jor im por tan ce for the de tec ti on of the ra pid prog res si on. K Ke ey y W Wo or rd ds s: : Lung di se a ses; mass chest X-ray; tho rax Ö ÖZ ZE ET T A Am ma aç ç: : Pul mo ner al ve o ler mik ro li ti azis (PAM), mik ro lit ola rak ad lan dı rı lan dif fuz sa yı la mayan kü çük kal ku lus la rın var lı ğı ile ka rak te ri ze na dir gö rü len idi yo pa tik bir has ta lık tır. Bu ça lış manın ama cı PAM has ta lı ğı nın rad yo lo jik bul gu la rı nı düz ak ci ğer gra fi si ve yük sek re zo lüs yon lu ak ci ğer to mog ra fi si (YRBT) arac lı ğı ile be ra ber or ta ya koy mak tır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 1996 yı lın -da ay nı köy den baş vu ran üç has ta ya PAM ta nı sı koy duk. 2005 yı lın da bi lin me yen ol gu la rı araş tır -mak ama cıy la ay nı köy de ya şa yan 279 ki şi yi mik ro film ta ra ma tek ni ği kul la na rak araş tır dık. İla ve ten beş ki şiye PAM ta nı sı ko nul du ve YRBT çe kil di. Top lam se kiz has ta nın YRBT ve düz gra fi le ri özel -lik le pul mo ner anor mal lik le rin pa ter ni, da ğı lı mı ve tu tu lu mu açı sın dan de ğer len di ril di. B Bu ul l g gu u l la ar r: : Se kiz ol gu nun dör dü...

Pulmonary alveolar microlithiasis with low fluorodeoxyglucose accumulation in PET/computed tomography

“…The most common chest X-ray findings in children is ground-glass opacities. [46] This finding represents the initial stage of the microscopic calcifications that are later followed by macroscopic calcific depositions. [4] Other less common findings are including bullae in the lung apices, black pleural lines, and pleural calcifications.…”

“…There are several studies indicating CT findings of PAM. [ 5 6 ] However, we could find only one study demonstrating abnormal accumulation of fluorodeoxyglucose (FDG) in both the lung-sparing calcification. [ 3 ] In this paper, we reported the first case of 27-year-old female with PAM presenting with low FDG uptake in FDG-Positron Emission Tomography (PET)/CT.…”

Diffuse pulmonary uptake of bone-seeking radiotracer in bone scintigraphy of a rare case of pulmonary alveolar microlithiasis

“…Because the pattern of radiographic findings is typical and nearly pathognomonic,[ 4 ] other imaging and nonimaging modalities such as CT, BAL and transbronchial biopsy might be avoided in the presence of the typical radiological appearance. [ 3 9 10 ] The characteristic CXR findings in adults are ground-glass or fine sand-like or nodular pattern opacities that are more prominent in the middle and lower zones of the lungs. The calcification may be so dense that may wipe out the heart borders and the diaphragm.…”

“…The use of high-resolution CT (HRCT) allows the identification of minimal findings in the lung parenchyma. [ 9 ] HRCT may show thickening of the lobular septae in addition to the centrilobular distribution of microliths. [ 11 ]…”

A Case of Pulmonary Alveolar Microlithiasis Diagnosed by Transbronchial Biopsy

“…Usually restrictive pattern was detected on pulmonary function test, and family history was reported in almost half of the cases. Tanrıkulu et al [8] said that in a case series of eight patients with PAM in Turkey, PAM was more common in males. Although the majority of patients were asymptomatic, the most common symptoms were cough and shortness of breath.…”