Presentation
Cough, progressive shortness of breath.
Patient Data
Age: 30 years
Gender: Male
From the case:
Pulmonary alveolar proteinosis
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Non-contrast chest CT shows geographical zones of ground-glass opacities with thickening of interlobular septa which forms the so-called crazy paving pattern. The abnormality has a lower lobe predominance.
No pleural effusion. No mediastinal lymphadenopathy.
Case Discussion
The CT pattern of crazy paving in combination with ineffective antibacterial treatment and absence of changes on baseline CT (not shown here) is very suspicious for pulmonary alveolar proteinosis.
Bronchoalveolar lavage was performed: smears with alveolar macrophages, PAS-positive proteinaceous material.
The final diagnosis was pulmonary alveolar proteinosis.
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