Difference between revisions of "Pulmonary alveolar proteinosis"
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==Stains== | ==Stains== | ||
*PAS +ve -- material in airspace (surfactant).<ref name=pmid24424195>{{Cite journal | last1 = Ben-Dov | first1 = I. | last2 = Segel | first2 = MJ. | title = Autoimmune pulmonary alveolar proteinosis: Clinical course and diagnostic criteria. | journal = Autoimmun Rev | volume = | issue = | pages = | month = Jan | year = 2014 | doi = 10.1016/j.autrev.2014.01.046 | PMID = 24424195 }}</ref> | *PAS +ve -- material in airspace (surfactant).<ref name=pmid24424195>{{Cite journal | last1 = Ben-Dov | first1 = I. | last2 = Segel | first2 = MJ. | title = Autoimmune pulmonary alveolar proteinosis: Clinical course and diagnostic criteria. | journal = Autoimmun Rev | volume = | issue = | pages = | month = Jan | year = 2014 | doi = 10.1016/j.autrev.2014.01.046 | PMID = 24424195 }}</ref> | ||
==IHC== | |||
*Surfactant +ve.<ref name=pmid23821516>{{Cite journal | last1 = Albores | first1 = J. | last2 = Seki | first2 = A. | last3 = Fishbein | first3 = MC. | last4 = Abtin | first4 = F. | last5 = Lynch | first5 = JP. | last6 = Wang | first6 = T. | last7 = Weigt | first7 = SS. | title = A rare occurrence of pulmonary alveolar proteinosis after lung transplantation. | journal = Semin Respir Crit Care Med | volume = 34 | issue = 3 | pages = 431-8 | month = Jun | year = 2013 | doi = 10.1055/s-0033-1348472 | PMID = 23821516 }}</ref> | |||
==See also== | ==See also== | ||
Revision as of 18:41, 26 February 2014
Pulmonary alveolar proteinosis, abbreviated PAP, in an uncommon medical lung disease.
General
- Associated with smoking - particularily in men.[1]
Pathophysiology:
- GM-CSF (granulocyte-macrophage colony stimulating factor) signaling in macrophages/lack of GM-CSF.
- GM-CSF is required by alveolar macrophages to clear surfactant.
Classification:[1]
- Congenital:
- Abnormal surfactant.
- GM-CSF receptor defect.
- Secondary:
- Infections.
- Haematologic malignancy.
- Acquired:
- Dusts - interfere with macrophage function.
Clinical:
- Dyspnea & cough - gradual onset.
Radiology
- CXR: airspace disease.
- HRCT: "crazy paving" - see: http://radiographics.rsnajnls.org/cgi/content/figsonly/23/6/1509.
Microscopic
Features:
- Crap in the alveoli:
- "Dense bodies" - dead macrophages ("Chatter" in the alveoli).
- Edema - has pink stuff in the alveoli like PAP but no dense bodies.
DDx - may mimic:[2]
- Pulmonary edema.
- Pneumocystis pneumonia - exudates foamy & vacuolated.
- Pulmonary hemorrhage (acute). (???)
Images
www:
PAP - low mag. (WC)
PAP - high mag. (WC)
PAP - intermed. mag. (WC)
PAP - very high mag. (WC)
Images of DDx:
Stains
- PAS +ve -- material in airspace (surfactant).[4]
IHC
- Surfactant +ve.[5]
See also
References
- ↑ 1.0 1.1 Trapnell BC, Whitsett JA, Nakata K (December 2003). "Pulmonary alveolar proteinosis". N. Engl. J. Med. 349 (26): 2527-39. doi:10.1056/NEJMra023226. PMID 14695413. http://content.nejm.org/cgi/content/extract/349/26/2527.
- ↑ Leslie, Kevin O.; Wick, Mark R. (2004). Practical Pulmonary Pathology: A Diagnostic Approach (1st ed.). Churchill Livingstone. pp. 248. ISBN 978-0443066313.
- ↑ Leslie KO (May 2009). "My approach to interstitial lung disease using clinical, radiological and histopathological patterns". J. Clin. Pathol. 62 (5): 387–401. doi:10.1136/jcp.2008.059782. PMC 2668105. PMID 19398592. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668105/.
- ↑ Ben-Dov, I.; Segel, MJ. (Jan 2014). "Autoimmune pulmonary alveolar proteinosis: Clinical course and diagnostic criteria.". Autoimmun Rev. doi:10.1016/j.autrev.2014.01.046. PMID 24424195.
- ↑ Albores, J.; Seki, A.; Fishbein, MC.; Abtin, F.; Lynch, JP.; Wang, T.; Weigt, SS. (Jun 2013). "A rare occurrence of pulmonary alveolar proteinosis after lung transplantation.". Semin Respir Crit Care Med 34 (3): 431-8. doi:10.1055/s-0033-1348472. PMID 23821516.