CTICasesPulmonary Alveolar Proteinosis
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Imaging findings
Chest radiography shows diffuse, bilateral, confluent parenchymal opacities. Chest CT reveals a classic, widespread "crazy paving" pattern, characterized by ground-glass attenuation superimposed on thickened interlobular septa. Histological analysis of bronchoalveolar lavage fluid demonstrates PAS-positive lipoproteinaceous material within the alveoli.
Key takeaways
Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of surfactant in the alveoli due to impaired clearance, typically caused by anti-GM-CSF antibodies. Its hallmark imaging feature is the "crazy paving" pattern, and diagnosis can be confirmed via bronchoalveolar lavage, with therapeutic whole-lung lavage being the standard of care.
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