Presentation
Chronic cough, heavy smoker.
Patient Data
Age: 35 years
Gender: Male
From the case:
Alveolar proteinosis
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Central bilateral infiltrates with sparing of the apices and costophrenic angles. Normal lung volumes. No pleural effusion or PTX. Cardiomediastinal contours are normal.
Case Discussion
DDx for batwing opacities includes pulmonary edema, PCP, pulmonary hemorrhage and PAP.
This patient was suspected for PAP on clinical grounds and underwent bronchoscopy, with bronchial lavage confirming alveolar proteinosis with copious amounts of surfactant.