PMC3920425_01
Chest X-ray illustrating right basal consolidation.
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She had a slow to resolve right basal consolidation (Fig. 1), despite multiple courses of antibiotics.
CT scan showing a large area of irregular consolidation in the middle lobe extending into the upper lobe.
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Her CT scan showed a large area of irregular consolidation in the middle lobe, extending into the upper lobe (Fig. 2).
Lung Biopsy (Periodic acid Schiff stain): Alveolar spaces are filled by homogenous faintly eosinophilic material, staining positive on PAS stain and resistant to diastase digestion. The lung interstitium shows lymphatic dilation and a small collection of lymphocytes. The features are those of alveolar proteinosis.
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This excluded malignancy, however showed features of Pulmonary Alveolar Proteinosis (PAP) (Fig. 3).