Pulmonary Alveolar Microlithiasis:AIRP Best Cases in Radiologic-Pathologic Correlation

Abstract

Editor's Note.-RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).

A Case Report of Pulmonary Alveolar Microlithiasis: Focus on Radiologic Findings

“…The typical chest radiograph findings, as featured in our patient, are bilateral diffuse areas of micronodular "sand storm" calcifications that predominate in the middle and basal lung areas, which obliterate the margin of the heart and the diaphragm [3,4,10]. A hyperlucency area between the lung parenchyma and the ribs, known as the black pleural line, is usually demonstrated [3,10]. The chest radiographs in our patient corroborated the characteristic pattern described in the literature.…”

“…Radiological diagnosis is used as the main diagnosis of PAM, especially in the setting of limited diagnostic resources. The typical chest radiograph findings, as featured in our patient, are bilateral diffuse areas of micronodular "sand storm" calcifications that predominate in the middle and basal lung areas, which obliterate the margin of the heart and the diaphragm [3,4,10]. A hyperlucency area between the lung parenchyma and the ribs, known as the black pleural line, is usually demonstrated [3,10].…”

Progressive Sandstorm Lung in Pulmonary Alveolar Microlithiasis

“…PAM is a rare, slowly progressive disease featured by calcification within the alveoli that caused by disturbance in calcium and phosphate homeostasis. Genetic mutation of SCL 34A2 gene, which encodes a type IIb sodium-dependent phosphate transporter in type II alveolar cells has been reported in familial cases [1]. Dyspnea is the most common presenting symptom, although most patients remained asymptomatic until the third to fourth decade of life [1].…”

“…Genetic mutation of SCL 34A2 gene, which encodes a type IIb sodium-dependent phosphate transporter in type II alveolar cells has been reported in familial cases [1]. Dyspnea is the most common presenting symptom, although most patients remained asymptomatic until the third to fourth decade of life [1]. Chest radiographs typically reveals diffuse micronodular calcification, which has been described as "sandstorm lung" [1].…”

“…Dyspnea is the most common presenting symptom, although most patients remained asymptomatic until the third to fourth decade of life [1]. Chest radiographs typically reveals diffuse micronodular calcification, which has been described as "sandstorm lung" [1]. High-resolution CT can demonstrate symmetrically numerous calcifications and ground-glass opacity with subpleural and peribronchial distribution.…”