106 Pulmonary Alveolar Proteinosis

CASE 106

image Clinical Presentation

58-year-old woman complaining of progressive shortness of breath

image Radiologic Findings

Unenhanced chest CT axial (Figs. 106.1A, 106.1B, 106.1C, 106.1D; lung window) and coronal (Figs. 106.1E; lung window) images demonstrate bilateral symmetric ground glass and smooth reticular opacities diffusely throughout the lungs without a zonal predilection. The involved regions of lung parenchyma are sharply demarcated from adjacent normal lung. This combination of ground glass with reticular opacities creates a pattern of disease called “crazy paving.” Note the preservation of lung volume and the absence of lymphadenopathy and pleural effusion.

image Diagnosis

Pulmonary Alveolar Proteinosis

image Differential Diagnosis

• Edema

image Cardiogenic

image ARDS

image Acute Interstitial Pneumonia (AIP)

• Infection

image Pneumocystis jiroveci Pneumonia

image Viral Pneumonia

image Mycoplasma Pneumonia

image Bacterial Pneumonia

• Organizing Pneumonia

image Bronchiolitis Obliterans Organizing Pneumonia (BOOP)/Cryptogenic Organizing Pneumonia (COP)

• Neoplasia

image Adenocarcinoma in-situ

• Other

image Hemorrhage

image Pulmonary Alveolar Proteinosis

image Sarcoidosis

image Non-Specific Interstitial Pneumonia (NSIP)

image Lipoid Pneumonia

image Subacute Radiation Therapy–Related Pneumonitis (XRT)

image Discussion


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Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on 106 Pulmonary Alveolar Proteinosis

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