The appearance of pulmonary alveolar microlithiasis on dualenergy X-ray absorptiometry

Dual-energy X-ray absorptiometry (DEXA) scan has been widely used as standard method of assessing bonedensity. Artefacts and incidental findings are frequently encountered on the DEXA scan images, some of whichmay affect bone mineral density values and the others are only of incidental findings. In this case report, wepresent a 44-year-old male diagnosed with pulmonary microlithiasis that was confirmed on a transbronchialbiopsy. To our knowledge, we report the first case in the literature, describing the appearance of pulmonaryalveolar microlithiasis on DEXA scan with brief review of literature on both pulmonary alveolar microlithiasisand artifacts and incidental findings encountered on DEXA scan.

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Barbolini G, Rossi G, Bisetti A. Pulmonary alveolar microlithiasis. N Eng J Med 2002;347:69-70.

Sosman MC, Dodd GD, Jones WD, Pillmore GU. The familial occurrence of pulmonary alveolar microlithiasis. Am J Roentgenol Radium Ther Nucl Med 1957;77:947-1012.

Mariotta S, Ricci A, Papale M, De Clementi F, Sposato B, Guidi L, et al. Pulmonary alveolar microlithiasis: report on 576 cases published in the literature. Sarcoidosis Vasc Diffuse Lung Dis 2004;21:173-81.

Helbich TH, Wojnarovsky C, Wunderbaldinger P, Heinz-Peer G, Eichler I, Herold CJ. Pulmonary alveolar microlithiasis in children: radiographic and high-resolution CT findings. AJR Am J Roentgenol 1997;168:63-5.

Gasparetto EL, Tazoniero P, Escuissato DL, Marchiori E, Frare E Silva RL, Sakamoto D. Pulmonary alveolar microlithiasis presenting with crazy-paving pattern on high resolution CT. Br J Radiol 2004;77:974-6.

Fallahi B, Ghafary B, Fard-Esfahani A, Eftekhari M. Diffuse pulmonary uptake of bone-seeking radiotracer in bone scintigraphy of a rare case of pulmonary alveolar microlithiasis. Indian J Nucl Med 2015;30:277-9.

Hoshino H, Koba H, Inomata S, Kurokawa K, Morita Y, Yoshida K, et al. Pulmonary alveolar microlithiasis: high-resolution CT and MR findings. J Comput Assist Tomogr 1998;22:245-8.

Ito K, Kubota K, Yukihiro M, Izumi S, Miyano S, Kudo K, et al. FDG-PET/CT finding of high uptake in pulmonary alveolar microlithiasis. Ann Nucl Med 2007;21:415-8.

Bazzocchi A, Ferrari F, Diano D, Albisinni U, Battista G, Rossi C, et al. Incidental findings with dual-energy X-ray absorptiometry: spectrum of possible diagnoses. Calcif Tissue Int 2012;91:149-56.

Frye MA, Melton LJ 3rd, Bryant SC, Fitzpatrick LA, Wahner HW, Schwartz RS, et al. Osteoporosis and calcification of the aorta. Bone Miner 1992;19:185-94.

Martineau P, Bazarjani S, Zuckier LS. Artifacts and incidental findings encountered on dual-energy X-ray absorptiometry: atlas and analysis. Semin Nucl Med 2015;45:458-69.

Stewart CA, Hung GL, Garland DE, Rosen CD, Adkins R. Heterotopic ossification. Effect on dual-photon absorptiometry of the hip. Clin Nucl Med 1990;15:697-700.