EURORAD ESR

Case 14055

Proteinosis alveolar: radiologic and pathologic findings

Author(s)
A. Moujir Sánchez, J.L. Marrero Brito, M.C. Camacho García, A.B. Llanos Gonzalez, M. González Domínguez, S. Fettane Gómez

Spain; Email:alejandromsan@hotmail.com
 
Patient
male, 20 year(s)
 
 
  • Figure 1
    Thorax X-Ray

    Posteroanterior chest X-ray showing bilateral, symmetric and perihilar ground-glass opacities predominant in upper and middle lung fields.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 2
    Computed Tomography (axial)
     

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 3
    Computed Tomography (coronal)
     

    Coronal slices ilustrate better perihilar and symmetric distribution.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Coronal slices ilustrate better perihilar and symmetric distribution.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Coronal slices ilustrate better perihilar and symmetric distribution.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Coronal slices ilustrate better perihilar and symmetric distribution.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Coronal slices ilustrate better perihilar and symmetric distribution.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 4
    Transbronchial biopsy and bronchoalveolar lavage
     

    Transbronchial biopsy (Hematoxylin and eosin stain). Tissue obtained by transbronchial byopsy was insufficient, but we can see eosinophilic proteinaceus material

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Dense clumps of eosinophilic material are present within the proteinaceous material.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Pathology;

    The proteinaceous material stains with the PAS stain.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Pathology;

    The bronchoalveolar lavage (papanicolaou stain) showed abundant large acellular extracelular material. The grocott stain was negative.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
Posteroanterior chest X-ray showing bilateral, symmetric and perihilar ground-glass opacities predominant in upper and middle lung fields.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
CT shows a bilateral, perihilar and symmetric ‘crazy paving’ pattern: nodular ground glass opacities with superimposed thickening of interlobular septa bilateral.
 
Coronal slices ilustrate better perihilar and symmetric distribution.
 
Coronal slices ilustrate better perihilar and symmetric distribution.
 
Coronal slices ilustrate better perihilar and symmetric distribution.
 
Coronal slices ilustrate better perihilar and symmetric distribution.
 
Coronal slices ilustrate better perihilar and symmetric distribution.
 
Transbronchial biopsy (Hematoxylin and eosin stain). Tissue obtained by transbronchial byopsy was insufficient, but we can see eosinophilic proteinaceus material
 
Dense clumps of eosinophilic material are present within the proteinaceous material.
 
The proteinaceous material stains with the PAS stain.
 
The bronchoalveolar lavage (papanicolaou stain) showed abundant large acellular extracelular material. The grocott stain was negative.
 
 
 
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