Pulmonary alveolar microlithiasis

Contributed by Dept. of Nuclear Medicine, Christian Medical College, Vellore


A 35-year-old female patient presented with a history of nonspecific chest pain and cough for one year. Spirometric studies excluded an obstructive ventilatory defect . Lung volume study findings were consistent with a moderate restrictive ventilatory defect with Total Lung capacity of 2.15L (51.6% of predicted). Diffusing capacity for the alveolar volume ventilated was reduced.


Plain chest radiograph showed sand-like opacities, diffusely scattered, bilateral, micronodular areas of radio- opacity of calcific densities throughout the lungs with the classic “sandstorm” pattern throughout both lungs predominantly in the lower zones (Fig: 1).




Computerized tomographic scan revealed diffuse bilateral calcified fine nodular pattern with extensive septal thickening (Fig: 2).

Figure 3: Tc-99m methylene diphosphonate (MDP) Bone scintigraphy showing intense bilateral uptake of the radiopharmaceutical in the lungs.