Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 1347

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     


IMAGES Table of Contents   
Year : 1999  |  Volume : 9  |  Issue : 4  |  Page : 195-196
Images-pulmonary alveolar microlithiasis

1 Department of Radiology, JLN Hospital and Research Centre, Bhilai, India
2 Department of Pulmonary Medicine, JLN Hospital and Research Centre, Bhilai, India

Click here for correspondence address and email

Keywords: Lung, Pulmonary Alveolar Microlithiasis

How to cite this article:
Dwivedi M K, Pal R K, Borkar P B. Images-pulmonary alveolar microlithiasis. Indian J Radiol Imaging 1999;9:195-6

How to cite this URL:
Dwivedi M K, Pal R K, Borkar P B. Images-pulmonary alveolar microlithiasis. Indian J Radiol Imaging [serial online] 1999 [cited 2021 Feb 26];9:195-6. Available from:
Pulmonary alveolar microlithiasis is a rare disease of unknown origin in which calcific concretions collect in the alveolar spaces [1]. The alveolar walls gradually get scarified and slowly, severe physiologic impairment becomes apparent [2]. Most cases are diagnosed in the third to the fifth decade. Though the age range is wide there is some evidence that women are affected more than men in familial cases. There seems to be an equal distribution between the sexes in the sporadic cases [3]. No known cause for the disease has been identified and there appears to be no systemic disorder of calcium metabolism and no evidence for any exposure or immunologic abnormalities. Most authors feel that this is an inborn error of calcium metabolism that is confined to the lungs due to precipitation of these salts [1]. In over 50% of reported cases, a familial association with siblings has been established [2],[3].

   Case Report Top

A forty-two years old man was admitted with a history of cough with expectoration and progressive exertional dyspnea for the last six months. The expectorate contained sand like particles and there was no history of hemoptysis. On examination of the respiratory system harsh breath sounds with bilateral scattered creps were found, more so in the lung base. Clubbing was also present. Sputum for AFB was repeatedly negative.

   Discussion Top

The diagnosis of pulmonary alveolar microlithiasis is mainly radiological and is based on two findings [4].

  1. Characteristic radiological appearance.
  2. Clinico radiological dissociation.

The chest radiograph [Figure - 1] shows diffuse bilateral calcific infiltrates, which are seen predominantly in the lower lung zones. These infiltrates are alveolar in nature and produce an air bronchogram. Radiographic obliteration of heart borders, pulmonary hilum and diaphragmatic outlines, is also visualized. Often, a "black-pleura" sign is seen, due to the differential densities between the calcified lung and the pleural surfaces. CT scan [Figure - 2] confirms the calcific nature of the nodules and the presence of an air bronchogram in both lower lobes. Pleural calcification may also be demonstrated [5].

A chest radiograph is all that is needed for the diagnosis but confirmation with CT scan, scintigraphy or transbronchial lung biopsy can be done.

   References Top

1.Meyer HH, Gilbert ES, Kent G. A Clinical review of pulmonary microlitheasis. JAMA 1956; 161: 1153_57..   Back to cited text no. 1  [PUBMED]  
2.Prakash UBS, Basham SS, Rosenow EC.III, Brown ML, Payne WS. Pulmonary Alveolar microlithiasis. A review including ultrastructural and pulmonary function studies. May Clin Proc, 1983; 58: 290_300.   Back to cited text no. 2    
3.Josmen MC, Dodd GD, Jones WD, Pilmore GV. The familial occurrence of Pulmonary alveolar Microlithiasis. AJR 1957; 77: 947_1012.   Back to cited text no. 3    
4.Rabin CB, Baron MG. Pulmonary alveolar microlithiasis: Radiology of the chest. 2 ndsub ed. London: Williams and Wilkins, 1980: 474_76.   Back to cited text no. 4    
5.Wineselberg GG, Bvoller M, SachsM, Weinberg J. CT evaluation of pulmonary microlithiasis. J Comput Assist Tomography 1984; 8: 1029-1031.   Back to cited text no. 5    

Correspondence Address:
M K Dwivedi
Department of Radiology, JLN Hospital and Research Centre, Bhilai
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions


[Figure - 1], [Figure - 2]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  

    Case Report
    Article Figures

 Article Access Statistics
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal