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  • Title: Pulmonary alveolar microlithiasis presenting with crazy-paving pattern on high resolution CT.
    Author: Gasparetto EL, Tazoniero P, Escuissato DL, Marchiori E, Frare E Silva RL, Sakamoto D.
    Journal: Br J Radiol; 2004 Nov; 77(923):974-6. PubMed ID: 15507428.
    Abstract:
    Pulmonary alveolar microlithiasis (PAM) is an uncommon chronic disease characterized by calcifications within the alveoli and a paucity of symptoms in contrast to the imaging findings. We present a 59-year-old woman with a 4-year history of shortness of breath on exertion. Lung auscultation revealed random wheezes and fine and coarse crackles. Pulmonary function tests showed a restrictive pattern. The chest radiograph demonstrated a bilateral symmetric micronodular pattern. High resolution CT scan revealed diffuse ground-glass attenuation with superimposed septal thickening ("crazy-paving" pattern). The patient underwent a lung biopsy, which confirmed the diagnosis of PAM. Our case demonstrates that PAM needs to be considerate in the differential diagnosis of lung lesions that present with crazy-paving pattern on the high resolution CT.
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