Pulmonary alveolar proteinosis
A few months history of progressive cough and dyspnoea.
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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.
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."