[A case of pulmonary alveolar microlithiasis].

The patient was a 42-year-old man. When he was a third grade pupil of elementary school, he was diagnosed as having miliary tuberculosis. He was absent from school for 2 years for the treatment of the disease. However, miliary tuberculosis did not improve in spite of 2 years of treatment. At that time he was diagnosed as having pulmonary alveolar microlithiasis. He did not receive any treatment for the following 30 years. Recently, he visited our department because of occasional chest pain. The following tests were performed; chest CT, tomography, respiratory function test, RI test (99mTc bone scintigram and 67Ga scintigram) and bronchoscopy. Bronchoalveolar lavage (BAL) was performed of B5b, and transbronchial lung biopsy (TBLB) of left B5b, B8b, B9b and B10b to make the accurate diagnosis of pulmonary alveolar microlithiasis. This case of pulmonary alveolar microlithiasis with a protracted course of 30 years (in which chest X-ray films taken 27 years ago were available) is reported together with a discussion of the literature.