EURORAD ESR

Case 13963

Knowledge of shadows: Pulmonary alveolar proteinosis

Author(s)
Parra-Fariñas C, Andreu J, Persiva O, Varona E, Pallisa E, Almazán E, Ortiz-Andrade C, Prat JA, Hernandez C, Dyer Hartnett S, Comet R.

Vall d´Hebron Hospital,
Passeig de la Vall d'Hebron, 119-129;
Carrer de Bailen 158
Barcelona 08037, Spain;
Email:carmenparrafarinas@gmail.com
 
Patient
female, 39 year(s)
 
 
  • Figure 1
    Pulmonary function tests

    Pulmonary function tests showed restrictive pattern.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Conventional chest radiography
     

    Posteroanterior conventional chest X-ray revealed symmetric, bilateral alveolar opacities, without air bronchogram, showing a perihilar and basal distribution.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Acute;

    Left lateral conventional chest X-ray revealed symmetric, bilateral alveolar opacities, without air bronchogram, showing a perihilar and basal distribution.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 3
    High resolution computed tomography of the lungs
     

    Axial HRCT showed reticulations superimposing on ground-glass opacities forming a “crazy-paving” pattern with a geographic distribution: juxtaposition of healthy and sick zones.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Acute;

    Axial HRCT, coronal reconstruction, showed reticulations superimposing on ground-glass opacities forming a “crazy-paving” pattern with a geographic distribution: juxtaposition of healthy and sick zones.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 4
    Whole lung lavage

    Photograph of WLL demonstrating an opaque, milky-appearing fluid with sediments.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Instrumentation; Special Focus: Acute;
     
     
  • Figure 5
    Conventional chest radiography
     

    Posteroanterior conventional chest X-ray after one week of WLL showed improvement of the infiltrative process.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Comparative studies; Special Focus: Acute;

    Left lateral conventional chest X-ray after one week of WLL showed improvement of the infiltrative process.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Comparative studies; Special Focus: Acute;
     
     
  • Figure 6
    High resolution computed tomography of the lungs
     

    Axial HRCT after one week of WLL showed marked decrease in the extent of the opacities.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Comparative studies; Special Focus: Acute;

    Axial HRCT, coronal reconstruction, after one week of WLL showed marked decrease in the extent of the opacities.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Comparative studies; Special Focus: Acute;
     
     
Pulmonary function tests showed restrictive pattern.
 
Posteroanterior conventional chest X-ray revealed symmetric, bilateral alveolar opacities, without air bronchogram, showing a perihilar and basal distribution.
 
Left lateral conventional chest X-ray revealed symmetric, bilateral alveolar opacities, without air bronchogram, showing a perihilar and basal distribution.
 
Axial HRCT showed reticulations superimposing on ground-glass opacities forming a “crazy-paving” pattern with a geographic distribution: juxtaposition of healthy and sick zones.
 
Axial HRCT, coronal reconstruction, showed reticulations superimposing on ground-glass opacities forming a “crazy-paving” pattern with a geographic distribution: juxtaposition of healthy and sick zones.
 
Photograph of WLL demonstrating an opaque, milky-appearing fluid with sediments.
 
Posteroanterior conventional chest X-ray after one week of WLL showed improvement of the infiltrative process.
 
Left lateral conventional chest X-ray after one week of WLL showed improvement of the infiltrative process.
 
Axial HRCT after one week of WLL showed marked decrease in the extent of the opacities.
 
Axial HRCT, coronal reconstruction, after one week of WLL showed marked decrease in the extent of the opacities.
 
 
 
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