Identification of Rare Pulmonary Alveolar Microlithiasis in Maharashtra, India

Pulmonary alveolar microlithiasis (PAM) is a rare diffuse lung disease characterized by intra-alveolar deposition of calcium and phosphate. Clinically, the disease may remain static in some patients while it may progress to pulmonary fibrosis, marked hypoxemia and cor pulmonale in others. We report a case of a 44-year-old male, tailor by occupation, nonsmoker, presented with shortness of breath on exertion for three years. His chest radiograph showed bilateral diffuse calcifications and high-resolution computerized tomography (HRCT) scan showed “crazy paving pattern” involving diffuse bilateral lung parenchyma. Histopathology of lung biopsy with use of special stains confirmed the diagnosis of pulmonary alveolar microlithiasis. Patient refused any further intervention or lung transplant and lost to follow up after a year.