Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical "sandstorm" appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM.
Biopsy ; Calcinosis/*diagnosis/surgery ; Chronic Disease ; Genetic Diseases, Inborn/*diagnosis/surgery ; Humans ; *Incidental Findings ; Lung Diseases/*diagnosis/surgery ; Male ; Pulmonary Alveoli/pathology/radiography ; Thoracic Surgery, Video-Assisted/methods ; Tomography, X-Ray Computed/*methods ; Young Adult