A young female with miliary mottling in her chest X-ray

Abstract

The presence of miliary nodular shadows in the chest radiograph although points to the classical diagnosis of miliary tuberculosis in endemic areas, persistence of these shadows on treatment and the disease presentation may alter the diagnosis. The combination of miliary mottling on chest radiograph along with the high-resolution computed tomography appearance of crazy-paving pattern with calcifications along the interlobular septa in the correct clinical context is considered diagnostic of pulmonary alveolar microlithiasis (PAM). The combination of above radiological features in one such case is presented here where histopathological examination of the lung proved the diagnosis of PAM.