A 48-year-old female patient was referred to our clinic for bone scintigraphy because of severe osteoporosis (L1–L4 T score was −3.5; serum calcium values and 24-h calciuria in normal range).
Bone scintigraphy showed bilateral, intense pulmonary 99mTc-methylenediphosphonate uptake, which led us to clinical suspicion of PAM. The chest radiograph revealed extensive, bilateral micronodular sand-like appearance, predominantly in the lower lung fields .
The diagnosis of PAM was confirmed by transbronchial lung biopsy.
Although the bone scintigraphy finding is sometimes negative in the early stage of PAM , this imaging method could be very useful in the detection of PAM.
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Horvatić Herceg, G., Bračić, I., Koršić, M. et al. “Sandstorm” image: bone scintigraphy in pulmonary alveolar microlithiasis. Eur J Nucl Med Mol Imaging 36, 1353 (2009). https://doi.org/10.1007/s00259-009-1137-6
- Serum Calcium
- Chest Radiograph
- Calcium Phosphate
- Clinical Suspicion