Nasir A. Siddiqui, MD , Carl R. Fuhrman, MD
History
A 48-year-old man presented with shortness of breath that had worsened over the previous few years. He reported that he became short of breath during mild exertion. He denied having a recent history of respiratory tract infection, and although he had a slight cough, sputum production was minimal. He said that he had smoked one pack of cigarettes per day for 16 years but had stopped smoking because of increasing dyspnea. He reported that his sister had expe¬rienced similar breathing problems and had undergone lung transplantation. He recalled that chest radiographs obtained in his childhood had shown lung abnormalities. His blood oxygen saturation while breathing ambient room air was 88%. Pul-monary function studies revealed severe restrictive lung disease with diminished diffusing capacity.
Imaging Findings
Posteroanterior and lateral chest radiographs depicted a diffuse fine sandlike micronodular pattern in both lungs, predominantly in the middle and lower zones (Fig 1). A vertical linear radiolucent area was observed between the pleu¬ra and ribs on the lateral radiograph. High-resolution computed tomographic (CT) images demonstrated wide¬spread tiny microcalcifications throughout the lungs, with the highest concen¬tration being seen in the anterior segments of the upper lobes (Fig 2). Areas of interlobular septal thickening and ground-glass opacification were noted.