CTICasesAluminum Dust-Induced Alveolar Proteinosis
Imaging findings
High-resolution chest CT demonstrates diffuse, geographic ground-glass opacities with superimposed smooth interlobular and intralobular septal thickening, presenting a classic 'crazy-paving' pattern, along with areas of consolidation. Lung biopsy confirmed pulmonary alveolar proteinosis (PAP) with co-existing aluminum particles.
Key takeaways
Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung disease characterized by the intra-alveolar accumulation of surfactant-like phospholipid material. While most cases are autoimmune (idiopathic) due to anti-GM-CSF antibodies, secondary PAP can be triggered by occupational exposures to inorganic dusts, most commonly silica, but rarely aluminum dust or indium. This patient, a construction worker, represents a rare case of aluminum dust-induced secondary PAP, which clinically improved following whole-lung lavage.
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