Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging

Pulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by accumulated calcium and phosphate crystals within the alveoli. Although PAM can be suspected in patients with clinical-radiological dissociation and characteristic imaging findings on chest computed tomography, def...

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Main Authors: Nam Nguyen-Thanh, MD, Ngoc Duong-Minh, MD, Khoa Nguyen-Dang, MD, Thong Pham-Quang, MD, Nam Vu-Hoai, MD, PhD, Vu Le-Thuong, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325002729
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author Nam Nguyen-Thanh, MD
Ngoc Duong-Minh, MD
Khoa Nguyen-Dang, MD
Thong Pham-Quang, MD
Nam Vu-Hoai, MD, PhD
Vu Le-Thuong, MD, PhD
author_facet Nam Nguyen-Thanh, MD
Ngoc Duong-Minh, MD
Khoa Nguyen-Dang, MD
Thong Pham-Quang, MD
Nam Vu-Hoai, MD, PhD
Vu Le-Thuong, MD, PhD
author_sort Nam Nguyen-Thanh, MD
collection DOAJ
description Pulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by accumulated calcium and phosphate crystals within the alveoli. Although PAM can be suspected in patients with clinical-radiological dissociation and characteristic imaging findings on chest computed tomography, definitive diagnosis requires a family history of PAM, identification of SLC34A2 gene mutations, or lung biopsy to exclude differential diagnoses. We report a case of a 66-year-old female incidentally found to have diffuse pulmonary calcifications. The diagnosis was confirmed through typical imaging features, transbronchial lung biopsy, and a family history of PAM. This case highlights the hallmark imaging characteristics of PAM and the critical role of transbronchial lung biopsy in establishing a definitive diagnosis. As PAM is a rare disease with no established consensus on treatment, except for lung transplantation, symptomatic management remains a significant challenge.
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issn 1930-0433
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publishDate 2025-07-01
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series Radiology Case Reports
spelling doaj-art-0f630090838d4ffc8f586b3bbd248b5d2025-08-20T03:49:42ZengElsevierRadiology Case Reports1930-04332025-07-012073167317010.1016/j.radcr.2025.03.065Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imagingNam Nguyen-Thanh, MD0Ngoc Duong-Minh, MD1Khoa Nguyen-Dang, MD2Thong Pham-Quang, MD3Nam Vu-Hoai, MD, PhD4Vu Le-Thuong, MD, PhD5Department of Pulmonary Medicine, Cho Ray Hospital, Ho Chi Minh City, VietnamDepartment of Pulmonary Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam; Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Pulmonary Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam; Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Pathology, Cho Ray Hospital, Ho Chi Minh City, VietnamDepartment of Pulmonary Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam; Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; Corresponding author.Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; Respiratory Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VietnamPulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by accumulated calcium and phosphate crystals within the alveoli. Although PAM can be suspected in patients with clinical-radiological dissociation and characteristic imaging findings on chest computed tomography, definitive diagnosis requires a family history of PAM, identification of SLC34A2 gene mutations, or lung biopsy to exclude differential diagnoses. We report a case of a 66-year-old female incidentally found to have diffuse pulmonary calcifications. The diagnosis was confirmed through typical imaging features, transbronchial lung biopsy, and a family history of PAM. This case highlights the hallmark imaging characteristics of PAM and the critical role of transbronchial lung biopsy in establishing a definitive diagnosis. As PAM is a rare disease with no established consensus on treatment, except for lung transplantation, symptomatic management remains a significant challenge.http://www.sciencedirect.com/science/article/pii/S1930043325002729Pulmonary alveolar microlithiasisTransbronchial lung biopsySLC34A2Clinical-radiological dissociation
spellingShingle Nam Nguyen-Thanh, MD
Ngoc Duong-Minh, MD
Khoa Nguyen-Dang, MD
Thong Pham-Quang, MD
Nam Vu-Hoai, MD, PhD
Vu Le-Thuong, MD, PhD
Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
Radiology Case Reports
Pulmonary alveolar microlithiasis
Transbronchial lung biopsy
SLC34A2
Clinical-radiological dissociation
title Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
title_full Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
title_fullStr Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
title_full_unstemmed Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
title_short Pulmonary alveolar microlithiasis with minimal symptoms and near-complete whiteout on chest imaging
title_sort pulmonary alveolar microlithiasis with minimal symptoms and near complete whiteout on chest imaging
topic Pulmonary alveolar microlithiasis
Transbronchial lung biopsy
SLC34A2
Clinical-radiological dissociation
url http://www.sciencedirect.com/science/article/pii/S1930043325002729
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