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Pulmonary alveolar proteinosis

Case contributed by Hani Makky Al Salam
Diagnosis probable

Presentation

Shortness of breath since 4 days.

Patient Data

Age: 35 years
Gender: Male
x-ray

Diffuse alveolar opacities are noted in bilateral mid and lower zones. 

Diffuse widespread ground glass opacities with superimposed smooth interlobular septal thickening giving a typical appearance called "crazy paving pattern" which is characteristically seen in pulmonary alveolar proteinosis. 

Case Discussion

Chest x-ray demonstrates small acinar opacities mimicking a miliary pattern.

CT scan of the chest shows widespread bilateral ground-glass opacities with superimposed smooth interlobular septal thickening referred to as crazy paving which is seen in pulmonary alveolar proteinosis.

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