Pulmonary alveolar microlithiasis with low fluorodeoxyglucose accumulation in PET/computed tomography

Area of Science:

• Pulmonology
• Radiology
• Nuclear Medicine

Background:

• Pulmonary alveolar microlithiasis (PAM) is a rare interstitial lung disease characterized by diffuse intraalveolar calcifications.
• Diagnosis is typically based on characteristic radiological findings on chest X-ray and CT scans.

Observation:

• A 27-year-old female presented with a 5-year history of shortness of breath.
• Radiological imaging confirmed Pulmonary alveolar microlithiasis.
• FDG-PET/CT was performed to assess for inflammation prior to anti-inflammatory treatment.

Findings:

• Dense calcifications in the lungs showed low FDG uptake (SUVmax: 2.7).
• Non-calcified lung regions also exhibited low FDG uptake.
• No significant inflammation was detected to warrant anti-inflammatory therapy.

Implications:

• FDG-PET/CT can help evaluate metabolic activity in Pulmonary alveolar microlithiasis.
• Findings suggest limited inflammatory component in this case, influencing treatment strategy.
• Management focused on symptomatic relief with bronchodilators (salbutamol).