CTICasesPulmonary Alveolar Proteinosis (PAP)
Imaging findings
Chest radiograph reveals bilateral, symmetric alveolar opacities. The corresponding chest CT shows a classic crazy-paving pattern characterized by ground-glass opacification with superimposed, thickened interlobular and intralobular septa, highly characteristic of pulmonary alveolar proteinosis.
Key takeaways
Pulmonary alveolar proteinosis is a rare disease characterized by the abnormal intra-alveolar accumulation of surfactant-derived lipoproteinaceous material due to impaired macrophage clearance. The crazy-paving pattern is a classic but non-specific CT manifestation of pulmonary alveolar proteinosis, which can also be seen in various infectious, inflammatory, and neoplastic conditions.
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