Pulmonary alveolar proteinosis: Difference between revisions
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| Prevalence = uncommon | | Prevalence = uncommon | ||
| Bloodwork = anti-GM-CSF antibodies, LDH elevated | | Bloodwork = anti-GM-CSF antibodies, LDH elevated | ||
| Rads = airspace disease, "crazy paving" | | Rads = airspace disease, "[[crazy paving]]" | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = benign | | Prognosis = benign | ||
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==Gross== | ==Gross== | ||
[[File:Crazy paving pattern on chest CT scan.jpg|thumb|Chest CT showing [[crazy paving]] pattern. (WC/Verma)]] | |||
*Consolidation. | *Consolidation. | ||
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===Radiology=== | ===Radiology=== | ||
*CXR: airspace disease. | *CXR: airspace disease. | ||
*HRCT: "[[crazy paving]]". | *HRCT: "[[crazy paving]]". | ||
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</pre> | </pre> | ||
===Micro=== | ====Micro==== | ||
Sections show lung with eosinophilic material in the airspaces. Focally, small (~20 micrometres), more dense appearing, bodies are also in the airspace. The alveolar walls are within normal limits. No significant inflammation is identified. No microorganisms are seen with routine stains. There is no pulmonary hemorrhage. | Sections show lung with eosinophilic material in the airspaces. Focally, small (~20 micrometres), more dense appearing, bodies are also in the airspace. The alveolar walls are within normal limits. No significant inflammation is identified. No microorganisms are seen with routine stains. There is no pulmonary hemorrhage. | ||
===Cytology=== | |||
In conjunction with history and imaging, PAP may be suggested on cytology.<ref name=pmid29607238>{{cite journal |authors=Li M, Alowami S, Schell M, Davis C, Naqvi A |title=Pulmonary Alveolar Proteinosis in Setting of Inhaled Toxin Exposure and Chronic Substance Abuse |journal=Case Rep Pulmonol |volume=2018 |issue= |pages=5202173 |date=2018 |pmid=29607238 |pmc=5828087 |doi=10.1155/2018/5202173 |url=}}</ref> | |||
<pre> | |||
Right Lung, BAL: NEGATIVE for Malignancy. Macrophages and amorphous material present in a dirty background, see comment. | |||
Comment: | |||
Satisfactory for evaluation. | |||
PAS POSITIVE and PSAD POSITIVE staining globules are present. GMS stain for pneumocystis is NEGATIVE. | |||
In the proper clinical context, the findings may be in keeping with pulmonary alveolar proteinosis (PAP). | |||
In the context of possible PAP, GM-CSF testing is suggested, if not already done. Please correlate with clinical and radiologic findings. | |||
The case was partially reviewed internally. | |||
</pre> | |||
==See also== | ==See also== | ||