Pulmonary alveolar microlithiasis is a rare disease in which radiological features precede the clinical presentation. Hence onus to diagnose lies more on radiologists. Characteristic findings of high resolution computed tomography are diagnostic of pulmonary alveolar microlithiasis. As the disease advances, lungs are filled up with sand (deposition of calcific nodules), patient succumbs to death.

Authors thought this disease as analogous to a sand clock. Share your views.