Korean J Radiol.  2013 Oct;14(5):859-862. 10.3348/kjr.2013.14.5.859.

Sandstorm Appearance of Pulmonary Alveolar Microlithiasis Incidentally Detected in a Young, Asymptomatic Male

• Ch'ng LS
• Bux SI
• Liam CK
• Rahman NA
• Ho CY

• KMID: 1711448
• DOI: http://doi.org/10.3348/kjr.2013.14.5.859

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical "sandstorm" appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM.

Keyword

Pulmonary alveolar microlithiasis; High resolution computed tomography; Calcospherites

MeSH Terms

Biopsy
Calcinosis/*diagnosis/surgery
Chronic Disease
Genetic Diseases, Inborn/*diagnosis/surgery
Humans
*Incidental Findings
Lung Diseases/*diagnosis/surgery
Male
Pulmonary Alveoli/pathology/radiography
Thoracic Surgery, Video-Assisted/methods
Tomography, X-Ray Computed/*methods
Young Adult

Figure

• 

  Fig. 1 Pulmonary alveolar microlithiasis. A. Frontal chest radiograph showing classic sandstorm-like appearance of pulmonary alveolar microlithiasis with symmetrical pattern of diffuse fine micronodules in both lungs and partial obscuration of heart border (arrows). B. Axial HRCT image of lower chest in bone window (top most) and mediastinal window (middle) showing diffuse pattern of microlithiasis, consisting of both discrete nodules and calcified interlobular septae (arrows); and in lung window (bottom most) showing areas of ground-glass attenuation in lung parenchyma (*). C. Axial HRCT image of lung at level of aortic arch in lung window showing subpleural cystic changes (arrows). D. Photomicrograph of section of resected lung tissue showing numerous laminated calcospherites (arrows) within alveolar spaces.

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