PULMONARY ALVEOLAR MICROLITHIASIS

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare lung disease characterized by the deposition of calcium in the alveolar spaces and bilateral diffuse micronodular ‘‘sandstorm'' radiographic pattern. The current report presents the case of a 19-yearold woman with pulmonary alveolar microlithiasis. The patient presented with exertional dyspnea and cough for two months. The physical examination was within normal limits and respiratory sounds were normal. The chest x-ray revealed a bilateral diffuse micronodular pattern in the middle and the lower areas of both lungs. On the parenchymal window of thorax computed tomography, bilateral diffuse widespread millimetric calcified nodules that were more prominent in the lower lobes were observed. Whole body bone scintigraphy with technetium-99m revealed bilateral, diffuse, heterogeneous, increased uptake in the pulmonary parenchyma. Transbronchial biopsy forceps example obtained from left lung lower lobe by fiberoptic bronchoscopy intra-alveolar PAS (+) deposits displayed. The patient was diagnosed with PAM and continues to be followed-up on without treatment.

Keywords

• Bone scintigraphy, pulmonary alveolar microlithiasis

PULMONER ALVEOLAR MİKROLİTİYAZİS

Öz

Pulmoner alveoler mikrolitiyazis (PAM) alveollerde kalsiyum birikmesi ile karakterize nadir görülen bir akciğer hastalığıdır. Her iki akciğerde yaygın simetrik mikronodüler radyolojik patern mevcuttur. Bu yazıda 19 yaşında PAM tanısı alan bayan hasta sunulmuştur. Hasta 2 aydır egzersizle nefes darlığı ve öksürük yakınmasıyla başvurdu. Fizik muayene ve solunum sesleri normaldi. Akciğer grafisinde orta ve alt alanlarda bilateral yaygın mikronodüler patern saptandı. Bilgisayarlı toraks tomografisinde parankim penceresinde bilateral alt loblarda daha belirgin olmak üzere yaygın milimetrik kalsifiye nodüller izlenmekteydi. Teknesyum-99m ile yapılan tüm vücut kemik sintigrafisinde her iki hemitoraksta yumuşak doku alanlarında heterojen tarzda diffüz artmış aktivite tutulumu saptandı. Sol akciğer alt lobtan fiberoptik bronkoskopi ile elde edilen tranbronşial biyopsi örneğinde intra-alveoler PAS (+) depozitler gösterildi. Hasta PAM tanısı ile tedavisiz takibe alındı.

Anahtar Kelimeler

• Kemik sintigrafisi, pulmoner alveoler mikrolitiyazis

Kaynakça

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