Pneumothorax secondary to pulmonary alveolar microlithiasis.

Pulmonary alveolar microlithiasis (PAM) is a rare impairment of pulmonary phosphate clearance that leads to gradual precipitation of intra-alveolar calcium phosphate microliths. There is often a striking difference between alarming clinical imaging and a relatively well patient. Pneumothorax in PAM often only respond to surgical intervention.