PMC4904544_01
Initial chest radiograph, posterior-anterior view, showing hazy airspace opacification of the lower lobes bilaterally.
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Initial chest radiograph demonstrated hazy airspace opacification of the lower lobes bilaterally (Figure 1).
CT of the thorax depicting diffuse bilateral ground-glass opacities with intralobular septal thickening; the findings are reported by the radiologist to be a crazy paving pattern.
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Tomography (CT) of the thorax revealed diffuse bilateral ground-glass opacities with intralobular septal thickening, as well as mild mediastinal, pretracheal, and para-aortic lymphadenopathy (Figure 2). The findings were reported as a crazy paving pattern.
Photograph of the BAL fluid, demonstrating an opaque, milky appearance.
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BAL fluid from all lobes appeared thin and milky (Figure 3).
PAS-stained BAL preparation showing PAS positive globular material and supporting a diagnosis of PAP (magnification 400x).
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Under microscopic examination, the fluid contained scattered globular Periodic Acid-Schiff positive material, with no malignant cells, fungi, or hemosiderin-laden macrophages (Figures 4 and 5).
Papanikolaou stained BAL preparation showing abundant globular orangeophilic material along with a few macrophages and leukocytes (magnification 400x).
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fig5
Under microscopic examination, the fluid contained scattered globular Periodic Acid-Schiff positive material, with no malignant cells, fungi, or hemosiderin-laden macrophages (Figures 4 and 5).
Posterior-anterior chest radiograph after three sessions of WLL, demonstrating improvement of the infiltrative process.
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A radiograph taken before discharge showed improvement in her airspace disease (Figure 6).