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Diffuse Lung Disease: Fellow Case Report Slide: Diffuse Lung Disease |

A Case of Pulmonary Alveolar Microlithiasis

Sathish Kumar Krishnan, MD; Dhileepan Selvarajan, MD
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Medical College of Wisconsin, Greenfield, WI


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):506A. doi:10.1016/j.chest.2016.08.520
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SESSION TITLE: Fellow Case Report Slide: Diffuse Lung Disease

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Wednesday, October 26, 2016 at 11:00 AM - 12:15 PM

INTRODUCTION: Pulmonary alveolar microlithiasis (PAM) is a rare chronic lung disease characterized by deposition of calcium phosphate microliths in the alveoli.

CASE PRESENTATION: A 44 year old gentleman presented for right sided flank pain for 6 days. His past medical history included asthma and infertility. His vitals were stable. Physical exam was significant for mild tenderness in the right lower quadrant. CT of the abdomen showed multiple renal stones bilaterally and a 7 mm stone in the lower one third of right ureter. On day 2, he developed dyspnea. Physical exam revealed diffuse bilateral wheezing and coarse crackles. Chest X-ray showed bilateral diffuse micro-nodular opacities. CT of the chest showed bilateral diffuse calcified micronodules, interlobular septal thickening and pleural calcification. Biopsy of the lung showed concentrically arranged laminated calcified bodies and PAS-positive psammoma bodies-like microliths consistent with PAM. Considering his infertility and the diagnosis of PAM, an ultrasound of the scrotum was done, which revealed multiple calcified microliths in both the testes and epididymis.

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