Presentation
A few months history of progressive cough and dyspnea.
Patient Data
There are multiple areas of "crazy paving" involving both lungs in a random distribution. The pleural spaces are clear. The airways are normal. No mediastinal or hilar lymphadenopathy.
Case Discussion
Typical imaging features of crazy paving, which is a combination of:
- smooth thickening of interlobular and intralobular septal lines, and
- groundglass opacities
This patient was submitted to bronchoalveolar lavage further confirming the diagnosis of pulmonary alveolar proteinosis: "Microscopy: Smears showing acute inflammatory cells, alveolar macrophages, and background of PAS-positive proteinaceous material, all in keeping with alveolar proteinosis."