PULMONARY ALVEOLAR MICROLITHIASIS

REPORT OF FIVE CASES WITH SPECIAL REFERENCE TO ROENTGEN MANIFESTATIONS

¹ Assistant Professor of Radiology, American University of Beirut, Lebanon
² Assistant Professor of Medicine, American University of Beirut, Lebanon
³ Lecturer of Medicine of the American University of Beirut, Lebanon

1. Five cases of pulmonary alveolar microlithiasis are reported and the roentgenologic features are discussed.

2. Different patterns of distribution of the microliths were observed in the upper lobes. These included a fine ground glass appearance, streaky radiations and apparent crowding of microcalculi into nodules along the bronchovascular tree, which are believed to reflect an acinar pattern of distribution of the alveoli themselves.

3. Various changes noted at the bases were quite different from those of the upper lobe and were more indicative of chronic lung disease.

4. Intra-alveolar calcific deposits at the subpleural surfaces resulted in a radiopaque line that demarcated the lungs at the mediastinum, at the domes of the diaphragm and at the interlobar fissures. This reflected the pattern of distribution of alveoli, and the primary lobule at the extreme periphery of the lungs.

5. The "vanishing heart" phenomenon, B lines of Kerley, emphysematous blebs and a radiolucent line around the lungs representing the intact pleural membrane were the associated findings.

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