Pulmonary alveolar microlithiasis: Lungs of stone!

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disorder characterized by diffuse bilateral deposition of calcispherites in lung alveoli due to mutations in the SLC34A2 gene. Here, we presented a case of PAM in a young male who had been referred to our center to rule out miliary tuberculosis due to his chest radiography findings of bilateral extensive reticulonodular opacities. Possibility of PAM was considered here due to clinicoradiological dissociation and was confirmed with high-resolution computed tomography of the chest, which showed findings of Stage 2 PAM. Even though PAM has pathognomonic unique chest radiographic findings, it always poses a diagnostic challenge for physicians as it closely resembles other diseases including miliary tuberculosis, pneumoconiosis, and sarcoidosis. This case shows the need for thorough knowledge about PAM that physicians should have to reach at early prompt diagnosis and to avoid unnecessary need for invasive procedures.