Pulmonary alveolar microlithiasis
Worsening SOB. Vietnamese ethnicity.
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Diffuse increased density throughout the lungs, of calcific attenuation with a middle to lower zone predominance. On the left medially there is Increased lucency between dense lung parenchyma and ribs.
The increased lucency between dense lung parenchyma and ribs on the left is known as the black pleura sign.
The patient had a known history of pulmonary alveolar microlithiasis (PAM). His lung function was critically low and restrictive. He was treated successfully a year later with lung transplantation.