Pulmonary alveolar microlithiasis

Case contributed by Dr Yair Glick

Presentation

Passed out and fell. Incidental finding.

Patient Data

Age: 60 years
Gender: Female
X-ray

Displaced right midclavicular fracture.

Diffuse, extremely high density opacification of the lower and middle zones of both lungs, prominent linear and reticular opacities in the upper zones.

Right midclavicular fracture with pronounced displacement of the fracture ends. Fractures of right 2nd and 3rd ribs adjacent to their costochondral junctions.
Right pectoralis major hematoma. Contusion of the right breast.

Diffuse interstitial and alveolar calcification, most severe in the basal lower lobes and right subpleural lung. Minimal pericardial effusion.

NB: Although a CT angiogram was also acquired for the assessment of chest trauma, the non-contrast CT is intentionally shown here for a clear demonstration of the pulmonary calcifications.

Case Discussion

The putative diagnosis for the widespread pulmonary calcifications was pulmonary alveolar microlithiasis, although a differential diagnosis of byssinosis was also entertained - the patient was questioned regarding work history and exposure to dust and remarked that for years, they had had a cotton silo in their yard.

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Case information

rID: 68676
Published: 10th Jun 2019
Last edited: 10th Jun 2019
System: Chest, Trauma
Inclusion in quiz mode: Included
Institution: Laniado Hospital

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