Report of Two Cases of Pulmonary Alveolar Microlithiasis after Exposure to Mustard Gas

Pulmonary alveolar microlithiasis (PAM) is a rare disease of unknown etiology and pathogenesis. This disorder is characterized by intra-alveolar development and the deposition of microliths or calcispherites containing calcium phosphate. In approximately half of the reported cases a familial connection has been found. The lung tissue is hardened progressively leading to the deterioration of pulmonary hypertension and the occurrence of cor-pulmonale. Pulmonary fibrosis is also observed in association with PAM. Some authors have suggested that PAM may be a peculiar exudative response to a variety of hurts including pneumonia and rheumatic fever. We report tow cases that manifested PAM. Their pulmonary disease began after exposure to mustard gas in Iraq-Iran war. Our patients did not have any positive familial history of the disease. The diagnosis of microlithiasis was confirmed by chest X-Ray and lung biopsy. This disease does not have any definitive treatment، but lung transplantation procedure is carried out for end stage lung disease.