Single-lung transplantation for pulmonary alveolar microlithiasis: A case report  

作　　者：Xing-Yu Ren Xiang-Ming Fang Jing-Yu Chen Hao Ding Yan Wang Qiu Lu Jia-Lei Ming Li-Juan Zhou Hong-Wei Chen 

机构地区：[1]Department of Radiology,Wuxi People’s Hospital-Nanjing Medical University,Wuxi 214000,Jiangsu Province,China [2]Lung Transplantation Center,Wuxi People’s Hospital-Nanjing Medical University,Wuxi 214000,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2019年第22期3851-3858,共8页世界临床病例杂志

摘　　要：BACKGROUND Pulmonary alveolar microlithiasis(PAM)is a rare idiopathic lung disease characterized by the accumulation of innumerable microliths.Currently,effective therapeutics for PAM are not available,and the only treatment for end-stage lung disease is lung transplantation(LuTx).Further,there are few reports that focus on LuTx for the treatment of PAM,and the follow-up reports of postoperative imaging are even rarer.CASE SUMMARY A 52-year-old man presented to Shanghai Pulmonary Hospital in 2017 after experiencing shortness of breath and exacerbation.The patient was diagnosed with PAM and referred for single-LuTx(SLuTx)on March 14,2018.Preoperative imaging results from a chest X-ray demonstrated bilateral,diffuse,symmetrical,sandstorm-like radiopaque micronodules,and pneumothorax and a computed tomography scan revealed minute,calcified military nodules in both lungs.We performed a left SLuTx,and intraoperative pathology was consistent with PAM.One week after surgery,a chest X-ray revealed slight exudation of the left lung,and one month later,the left transplanted lung exhibited good dilation,mild pulmonary perfusion injury with local infection,and left pleural effusion.Fiberoptic bronchoscopy revealed left hyperplastic granulation at the left bronchial anastomosis.Multiple sputum cultures suggested the presence of Klebsiella pneumoniae and Acinetobacter baumannii.The last follow-up was conducted in April 2019;the patient recovered well.CONCLUSION This case presents the imaging findings of a patient with PAM before and after LuTx and confirms the effectiveness of LuTx for the treatment of this disease.BACKGROUND Pulmonary alveolar microlithiasis(PAM) is a rare idiopathic lung disease characterized by the accumulation of innumerable microliths. Currently, effective therapeutics for PAM are not available, and the only treatment for end-stage lung disease is lung transplantation(Lu Tx). Further, there are few reports that focus on Lu Tx for the treatment of PAM, and the follow-up reports of postoperative imaging are even rarer.CASE SUMMARY A 52-year-old man presented to Shanghai Pulmonary Hospital in 2017 after experiencing shortness of breath and exacerbation. The patient was diagnosed with PAM and referred for single-Lu Tx(SLu Tx) on March 14, 2018. Preoperative imaging results from a chest X-ray demonstrated bilateral, diffuse, symmetrical,sandstorm-like radiopaque micronodules, and pneumothorax and a computed tomography scan revealed minute, calcified military nodules in both lungs. We performed a left SLu Tx, and intraoperative pathology was consistent with PAM.One week after surgery, a chest X-ray revealed slight exudation of the left lung,and one month later, the left transplanted lung exhibited good dilation, mild pulmonary perfusion injury with local infection, and left pleural effusion.Fiberoptic bronchoscopy revealed left hyperplastic granulation at the left bronchial anastomosis. Multiple sputum cultures suggested the presence of Klebsiella pneumoniae and Acinetobacter baumannii. The last follow-up was conducted in April 2019; the patient recovered well.CONCLUSION This case presents the imaging findings of a patient with PAM before and afterLu Tx and confirms the effectiveness of Lu Tx for the treatment of this disease.

关 键 词：Pulmonary ALVEOLAR MICROLITHIASIS Lung TRANSPLANTATION COMPLICATIONS CHEST X-ray COMPUTED tomography Case report 

分 类 号：R73[医药卫生—肿瘤]