Can chest high-resolution computed tomography findings diagnose pulmonary alveolar microlithiasis?

• Published in: Radiologia brasileira Vol. 48; no. 4; pp. 205 - 210
• Main Authors: Francisco, Flávia Angélica Ferreira, Rodrigues, Rosana Souza, Barreto, Miriam Menna, Escuissato, Dante Luiz, Araujo Neto, Cesar Augusto, Silva, Jorge Luiz Pereira E, Silva, Claudio S, Hochhegger, Bruno, Souza, Jr, Arthur Soares, Zanetti, Gláucia, Marchiori, Edson
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 01.08.2015
• Subjects: Original; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; Pulmonary calcifications; High-resolution computed tomography; Pulmonary alveolar microlithiasis; Tomografia computadorizada de alta resolução; Microlitíase alveolar pulmonar; Calcificações pulmonares
• ISSN: 0100-3984; 1678-7099; 1678-7099
• DOI: 10.1590/0100-3984.2014.0123

The present study was aimed at retrospectively reviewing high-resolution computed tomography (HRCT) findings in patients with pulmonary alveolar microlithiasis in order to evaluate the frequency of tomographic findings and their distribution in the lung parenchyma. Thirteen patients (9 females and 4 males; age, 9 to 59 years; mean age, 34.5 years) were included in the present study. The HRCT images were independently evaluated by two observers whose decisions were made by consensus. The inclusion criterion was the presence of abnormalities typical of pulmonary alveolar microlithiasis at HRCT, which precludes lung biopsy. However, in 6 cases lung biopsy was performed. Ground-glass opacities and small parenchymal nodules were the predominant tomographic findings, present in 100% of cases, followed by small subpleural nodules (92.3%), subpleural cysts (84.6%), subpleural linear calcifications (69.2%), crazy-paving pattern (69.2%), fissure nodularity (53.8%), calcification along interlobular septa (46.2%) and dense consolidation (46.2%). As regards distribution of the lesions, there was preferential involvement of the lower third of the lungs. No predominance of distribution in axial and anteroposterior directions was observed.