Pulmonary alveolar proteinosis.

Abstract

Three adult patients, two of whom were HIV-seropositive, presented with a dyspnea of two-to-three-day duration associated with dry cough. High-resolution CT scans of the chest revealed a widespread air-space consolidation with "crazy-paving" pattern in all cases, suggesting a pulmonary alveolar proteinosis (PAP). Bronchoalveolar lavage (BAL) retrieved varying amounts of turbid fluid containing abundant, coarsely granular material that stained positively using periodic acid-Schiff (PAS) and PAS with prior diastase digestion. Pneumocystis carinii (PC) cysts were identified in Gomori methenamine silver-stained BAL sediments obtained from the two HIV-positive patients. By electron microscopy, numerous myelin figures were found in the BAL sediments in all cases, confirming a PAP. Histologic examination of lung tissues obtained by open biopsy confirmed a PAP in two cases, with one case showing, in addition, PC cysts.

• Authors: Marie-Rose Akin, Gia-Khanh Nguyen
• Journal: Pathology, research and practice (Pathol Res Pract) Vol. 200 Issue 10 Pg. 693-8; discussion 699-700 ( 2004) ISSN: 0344-0338 [Print] Germany
• PMID: 15648606 (Publication Type: Case Reports, Journal Article)

Chemical References

• Granulocyte-Macrophage Colony-Stimulating Factor

Topics

• Adult
• Animals
• Bronchoalveolar Lavage Fluid (microbiology)
• Cysts (microbiology, ultrastructure)
• Diagnosis, Differential
• Female
• Granulocyte-Macrophage Colony-Stimulating Factor (metabolism)
• HIV Infections (complications)
• Humans
• Male
• Microscopy, Electron, Transmission
• Middle Aged
• Pneumocystis carinii
• Pneumonia, Pneumocystis (complications, pathology)
• Pulmonary Alveolar Proteinosis (microbiology, pathology)