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©2013 UpToDate ® Print Email Alveolar microlithiasis Chest radiograph shows multiple calcified micronodules due to small intraalveolar calcospherites. A dark rind of noninvolved lung separates the pleura from the involved parenchyma and is called the "black pleura sign." It is actually caused by paraseptal emphysema. The cardiac silhouette is darker than the confluent calcified lung opacities. Courtesy of Paul Stark, MD. Normal chest radiograph Posteroanterior view of a normal chest radiograph. Courtesy of Carol M Black, MD.