Pulmonary alveolar lithiasis in two siblings

Pulmonary alveolar microlithiasis (PAM) is a rare disease of unknown etiolo gy and is characterized by the deposition of calcium phosphate microliths w ithin the alveolar airspaces. We report 2 asymptomatic siblings, a 7-year-o ld girl and her 13-year-old brother, with PAM. In the girl, chest X-ray and computed tomography revealed diffuse interstitial changes but no uptake of technetium 99m (Tc-99m) on bone scan was noted in the lung. Microliths sta ined pink with Papanicolaou dye in bronchoalveolar ravage fluid (BALF) but did not stain with von Kossa. In the brother, characteristic radiological f indings and Tc-99m uptake in the lung were detected, The microliths stained pink with Papanicolaou in BALF and black with von Kossa as well. We hypoth esize that the first case is in the early phase of PAM because of lack of T c-99m uptake. Copyright (C) 2001 S. Karger AG, Basel.