Pulmonary alveolar microlithiasis with calcified pleural plaques

Our plain-English summary of Pulmonary alveolar microlithiasis with calcified pleural plaques, by B. Malhotra, R. Sabharwal, M. Singh, et al (Lung India, 2010).

The study

• Authors: B. Malhotra, R. Sabharwal, M. Singh, A. Singh
• Journal: Lung India
• Published: 2010;27(4):250-2
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare disease. Herein we report a case of pulmonary alveolar microlithiasis who was suspected to have the disease on chest X-ray and was confirmed on high resolution CT and transbronchial lung biopsy. These investigations showed characteristic features of pulmonary alveolar microlithiasis with diffuse interstitial pulmonary fibrosis.

In plain English

This case report from Government Medical College Amritsar, India, described one patient with pulmonary alveolar microlithiasis, a rare lung disease in which tiny calcified bodies form in the air sacs. The patient was a 50-year-old male non-smoker and farmer with breathlessness on exertion for 25 years. A chest X-ray showed sand-like spots in both lungs, mostly in the middle and lower zones. CT scanning showed fibrosis, tiny calcified nodules in the air sacs, and multiple calcified plaques along the pleura on both sides, mainly in the lower lobes. A lung biopsy taken through a bronchoscope showed calcified spherules and fibrosis, which the authors said proved the diagnosis. Lung function tests showed a restrictive pattern, with vital capacity of 1.88 L (55% predicted). Serum calcium was low (6.4 mg/dl). Family members' chest X-rays were normal. The article does not mention asbestos or give a cause for the pleural plaques. The authors concluded that there is currently no effective medical therapy and that the X-ray picture may mimic miliary tuberculosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 50-year-old male non-smoker, a farmer, seen at the Department of Chest and TB, Government Medical College Amritsar, India, with breathlessness on exertion for 25 years; date of presentation not given
• Exposure: No exposure was studied. The article does not mention asbestos or any dust exposure; the only occupational detail given is that the patient was a farmer.
• Main results:
  • In this patient, the chest X-ray showed sand-like micronodular opacities in both lungs, more so in the middle and lower zones
  • In this patient, CT showed multiple calcified plaques along the costal pleura on both sides, mainly in the lower lobes, along with tiny calcified nodules within the alveoli and areas of fibrosis
  • In this patient, the transbronchial lung biopsy showed calcified spherules in the alveolar spaces and in the interstitium, with chronic inflammatory cells and areas of fibrosis
  • In this patient, lung function tests showed a restrictive defect, with vital capacity 1.88 L (55% predicted) and FEV1/FVC printed as 113%
  • In this patient, serum calcium was below normal at 6.4 mg/dl, which the authors thought was probably due to calcium deposition in the lung
  • The patient's family members were X-rayed, and none showed any abnormal finding
• The authors' conclusion: The authors concluded that there is currently no effective medical therapy, that affected people may progress to end-stage lung disease, and that the X-ray picture may mimic miliary tuberculosis

Topics

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Chest X-Ray, Biopsy, Interstitial, Pulmonary Fibrosis.

Related studies

• Hyaline and calcified pleural plaques as an index of exposure to asbestos — D.O. Hourihane, L. Lessof, et al. (1966)
• Subpleural fat pads in patients exposed to asbestos: distinction from non-calcified pleural plaques — E.N. Sargent, W.D. Boswell, et al. (1984)
• Calcified interlobar pleural plaques: visceral pleural involvement due to asbestos — E.N. Sargent, J.S. Felton, et al. (1981)
• Calcified plaques on mediastinal pleural reflections associated with asbestos dust exposure: four case reports — A. Solomon, G.K. Sluis-Cremer, et al. (1984)
• Calcified plaque in the superior portion of the major fissure. An unusual manifestation of asbestos exposure — S.B. Rupp, H. Jolles (1989)
• The Role of Mitochondrial DNA in Mediating Alveolar Epithelial Cell Apoptosis and Pulmonary Fibrosis — S.J. Kim, P. Cheresh, et al. (2015)

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