PMC5364198_01
(a, b) On plain chest radiography, bilateral alveolar opacities located centrally in mid and lower lung zones are found. (c, d) On high resolution CT reveals ground glass opacity accompanied by significant, diffuse hypertrophy of the interlobular septa of both lungs referred to as "crazy- paving".
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Plain chest X-ray and computed tomography (CT) showed ground glass opacity (GGO) accompanied by significant, diffuse hypertrophy of the interlobular septa of both lungs (Fig. 1).
(a, b) On trans bronchial lung biopsy, The terminal bronchioles and alveoli are filled with a PAS-positive eosinophilic material with a granular pattern. (c, d) On bronchoalveolar lavage fluid and suctioned sputum, we can find granule-like substances that tended to be stained light green and the presence of macrophages.
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On transbronchial lung biopsy, the alveolar space was filled with PAS-positive eosinophilic granule-like substances, consistent with PAP (Fig. 2A and B). Macrophages were also present in the BAL and sputum (Fig. 2C and D).