PULMONER ALVEOLER MİKROLİTİYAZİS: OLGU SUNUMU

Pulmoner alveoler mikrolitiyazis (PAM) intraalveoler bölgede kalsifik granüllerin birikimiyle karekterize nadir görülen bir hastalıktır. Kırk dört yaşında kadın hasta göz kanalında tıkanıklık nedeniyle planlanan operasyon öncesi çekilen akciğer radyogramında yaygın, bilateral, alt zonlarda yaygın kalsifiye mikronodüller görülmesi üzerine tetkik için servisimize yatırıldı. Yaklaşık 5-6 yıldır eforla gelen nefes darlığı tanımladı. Karbon monoksit difüzyon kapasitesi %71 olarak ölçüldü. Toraks yüksek rezolüsyonlu bilgisayarlı tomografisi PAM ile uyumlu olan hastaya fiberoptik bronkoskopi yapıldı. Hastaya histopatolojik olarak PAM tanısı konuldu. Orbita bilgisayarlı tomografisinde sol nazolacrimal kanal distalinde 6-7 mm çapında taş yönünden şüpheli görünüm ve nazolakrimal kanal stenozu saptandı. Nadir görülmesi nedeniyle olguyu literatür bilgileri ışığında sunuyoruz.

PULMONARY ALVEOLAR MICROLITHIASIS: CASE REPORT

Pulmonary alveolar microlithiasis (PAM) is a rare disorder usually presenting with extensive intra alveolar calcium deposition. 44 year old woman with nasolacrimal duct obstruction and chest radiogram showing extensive, bilateral, bazilary calcific micronoduler lesions was admitted to hospital for investigation. She told that she had sufferred breathlessness after an effort for 5-6 years. Carbon monoxide diffusion capacity was 71%. Fiberoptic bronchoscopy was performed to the patient whose thorax high resolution computed tomography was adjusted to PAM. She was diagnosed as PAM by histopathology. In her orbital computed tomography, nasolacrimal stenosis and an opacity suspected of microlith was detected. Because it is a rare disorder, we have presented the case by the light of literature.

___

  • 1. 1.Ochs RH, Fishman AP. Depositional diseases of the lungs. In: Fishman AP, Elias JA (eds). Pulmonary diseases and disorders. United States of America: McGraw-Hill; 1998: 154-6.
  • 2. Harbitz F. Extensive calcification of the lungs as a distinct disease. Arch Intern Med 1918; 21: 39-46.
  • 3. Y›lmaz A, Akaya E, Bayram Ü ve ark. Pulmoner alveoler mikrolitiyazisli bir olgu. Akci¤er Arflivi 2004; 1: 40-2.
  • 4. Aksel N, fiahin B, Özsöz A. Pulmoner alveoler mikrolitiyazis: olgu sunumu. ‹zmir Gö¤üs Hastanesi Dergisi, 2005: 9: 65-9.
  • 5. Çiftçi B. Pulmoner alveoler mikrolitiyazis. Solunum 20080. Diffüz parankimal akci¤er hastal›klar› özel say›s›: 104-9.
  • 6. Okutan O, Kartalo¤lu Z, ‹lvan A ve ark. Yeni tan› konulmufl ailesel alveoler mikrolitiyazis (iki erkek kardefl olgu sunumu) Toraks Dergisi 2007; 8: 127-9.
  • 7. Portnoy LM, Amedeo B, Henningar GR. Pulmonary alveolar microlithiasis: an unusual case (associated with milk-alkalisendrome). Am J Clin Pathol 1964; 41: 194-201.
  • 8. Pant K, Shah A, Mathue RK, et al. Pulmonary alveoler microlithiazis with pleural calcification and nephrolithiasis. Chest 1990; 98: 245-6.
  • 9. Huqun, Izumi S, Miyazawa H et al. Mutations in the SLC34A2 gene are associated with pulmonary alveoler microlithiasis. Am J Respir Crit Care Med 2007; 175: 263-8.
  • 10. Uçan ES, Keyf AL, Aydilek R, et al. Pulmonary alveolar microlithiasis: review of Turkish reports. Thorax 1993; 48: 171-3.
  • 11. Deniz Ö. Pulmoner alveoler mikrolitiyazis. Tuberküloz ve Toraks Dergisi 2005; 53: 293-8.
  • 12. fienyi¤it A, Yoramis A, Gürkan F. et al. Pulmonary alveoler microlithiasis: a rare familial inheritance with report of six cases in a family: contribution of six new cases to the number of case reports in Turkey. Respiration 2001; 68: 204-9.
  • 13. Vole E, Kaufman HJ. Pulmonary alveolar microlithiasis in pediatric patients. Review of the world literature and typ new observations. Pediatr Radiol 1987; 17: 439-42.
  • 14. Emri S, Çöplü L, Selçuk T, et al. Hypertrophic pulmonary osteoartropathy in a patient with pulmonary alveolar microlithiasis. Thorax 1991; 46: 145-6.
  • 15. Marchiori E, Goncalves CM, Escuissato DL. Pulmonary alveolar microlithiasis: high resolution computed tomography findings oin 10 patients J Bras Pneumol. 2007; 33: 123-6.
  • 16. Chang YC, Yang PC, Luh KT, et al. High resolution computed tomography of pulmonary alveolar microlithiasis. J Farma Med Assoc 1999; 98: 440-3.
  • 17. Türktafl H, Oztürk C, Güven M, et al. Pulmonary alveolar microlithiasis with the absence of technetium-99m MDP uptake of lungs. Clin Nucl Med 1998; 13: 883-5.
  • 18. Lauta VM. Pulmoner alveolar microlithiasis: an overview of clinical and pathological features together with possible therapies. Respir Med 2003; 97: 1081-5.
  • 19. Göçmen A, Toppare MF, Kiper N, et al. Treatment of pulmonary alveolar microlithiasis with a diphosphonate- preliminary results of a case. Respiration 1992; 59: 250-2.