Pulmonary alveolar proteinosis

Case contributed by Stefan Tigges
Diagnosis almost certain

Presentation

Referred from an outside hospital with shortness of breath.

Patient Data

Age: 65 years
Gender: Female
x-ray
Frontal
Lateral
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Info

Widespread bilateral increased opacity, normal cardiomediastinal silhouette, no pleural effusion.

This study is a stack
Axial lung
window
This study is a stack
Axial lung
window
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
lung window
This study is a stack
Sagittal
lung window
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Info

Widespread geographic "crazy paving" pattern (septal thickening + ground glass opacity).

Case Discussion

A crazy-paving pattern is characteristic of but not diagnostic of pulmonary alveolar proteinosis, however the radiological differential diagnoses which include oedema, infection and haemorrhage are all acute illnesses. In this case, a diagnosis of pulmonary alveolar proteinosis had been made at an outside hospital and the patient was referred to our hospital for treatment with bronchoalveolar lavage.

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