CTICasesAlveolar Proteinosis
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Imaging findings
The patient presented with bilateral, asymmetric consolidations and "crazy paving" patterns, with relatively spared areas. The imaging findings were notable for the degree of consolidation compared to the crazy paving, a feature that did not initially suggest alveolar proteinosis. Diagnostic confirmation was obtained via bronchoalveolar lavage, which yielded characteristic cloudy fluid.
Key takeaways
Alveolar proteinosis can present with profound consolidation and crazy paving, sometimes masking the classic diagnosis. Clinicians should maintain a high index of suspicion in immunocompromised patients, even when the presentation seems atypical or asymmetric, and consider whole lung lavage as both a diagnostic and therapeutic intervention.
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