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- Pulmonary Alveolar MicrolithiasisPublication . Rodrigues, H; Belo-Oliveira, P; Donato, P; Caseiro-Alves, FRoutine chest x-ray of an asymptomatic patient disclosed an interstitial bilateral micronodular pattern. HRCT showed a diffuse micronodular pattern, randomly distributed in the lung parenchyma, associated with thickening of the subpleural and mediastinal interlobular septa. Individual nodules had spontaneous high density. CT-guided lung biopsy was performed, pathologist disclosed intraalveolar microliths.