A case of pulmonary alveolar microlithiasis with Cor Pulmonale

Wen Chen1, Tao Gu

  • 1Department of Radiology, Beijing Hospital, the Fifth Clinical Medicine College of Peking University, Beijing, China.

Insights

Pulmonary alveolar microlithiasis (PAM), a rare lung disease, involves microlith deposits. This case highlights its association with Cor Pulmonale and diagnostic imaging findings.

Area of Science:

  • Pulmonology
  • Rare Diseases
  • Genetics

Background:

  • Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disorder.
  • Mutations in the SLC34A2 gene are associated with PAM.
  • PAM is characterized by microlith deposition in lung alveoli, often with subtle symptoms.

Observation:

  • A case of PAM presenting with Cor Pulmonale is described.
  • Echocardiography revealed pulmonary hypertension (82 mmHg).
  • Chest radiography showed diffuse, bilateral sandstorm-like micronodules, predominantly in lower lung fields.

Findings:

  • High-resolution CT (HRCT) scans demonstrated ground-grass opacities, thickened/calcified interlobular septa, and confluent calcified nodules.
  • Diagnosis was suspected based on imaging characteristics.
  • Transbronchial lung biopsy (TBLB) confirmed the presence of microliths, establishing the PAM diagnosis.

Implications:

  • This case underscores the importance of characteristic imaging findings in diagnosing PAM.
  • Understanding PAM's presentation aids in early detection and management of associated conditions like Cor Pulmonale.
  • Further research into SLC34A2 gene mutations can improve diagnostic accuracy and therapeutic strategies for PAM.

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