Presentation
Check ICC position.
Patient Data
Age: 30 years
Gender: Male
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Small left pneumothorax with a left apically directed intercostal catheter in situ. (This was iatrogenic in this case)
Bilateral diffuse symmetrical airspace opacities. No pleural effusion. Normal heart size.
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Relatively symmetrical bilateral multilobar ground glass opacities and septal thickening - crazy paving.
Well-defined geographic regions of spared normal lung.
Pleural spaces are clear.
No mediastinal lymphadenopathy.
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Markedly reduced ground glass opacities and septal thickening post whole lung lavage.
Case Discussion
Lung Lavage Cytopathology: Large amount of PAS+ proteinaceous fluid. GMS stain negative for fungi and PJP.
Anti GM-CSF antibody: positive.
Conclusion: pulmonary alveolar proteinosis
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