Presentation
Dry cough in the last month.
Patient Data
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Bilateral widespread groundglass opacities associated with interlobular septal thickening and a few spared pulmonary lobules with normal attenuation giving the "crazy-paving" pattern, particularly within the lower lobes. No air-traping. No pleural effusion. No suspicious lymphadenopathy.
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Patchy ground glass opacities predominantly involving the mid and lower zones. No pleural effusions.
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Significant interval improvement with the lungs mostly clear and only some residual perihilar infiltrates.
Case Discussion
This patient has had lung biopsy performed before being transferred to our institution. Both the biopsy and further bronchoalveolar lavage confirmed pulmonary alveolar proteinosis.
The HRCT images show the classic crazy-paving pattern within the lower lobes.