Adult female with mild symptoms of cough and dyspenoa on excertion.
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High resolution CT scan reveals diffuse ground-glass attenuation and septal thickening with calcified nodules, defining the "crazy-paving" pattern. Calcifications of subpleural aspect are also seen.
Pulmonary alveolar microlithiasis (PAM) is an uncommon chronic disease characterized by calcifications within the alveoli and a paucity of symptoms in contrast to the imaging findings.
Pulmonary function tests in this patient showed a restrictive pattern.
The chest radiograph demonstrated a bilateral symmetric micronodular pattern (not shown).
The patient underwent a lung biopsy, which confirmed the diagnosis of PAM.
PAM needs to be considered in the differential diagnosis of lung lesions that present with crazy-paving pattern on the high resolution CT.