PMC5633158_01
a and b. Thorax CT showed a bilateral, diffuse infiltrate with a crazy paving distribution.
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PMC5633158_01_gr1.jpg
fig1
Histopathological study showed intra alveolar deposit of lipoprotein material wrapped by a thickened wall due to inflammatory cell and type 2 pneumocytes.
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fig2
The overall pathology was compatible with pulmonary alveolar proteinosis (PAP) (Fig. 2).
Differential lavage of lung material. Left: initial lavage; right: Final lavage.
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fig3
The sessions were separated by 21 days; the first session included the right lung, and the second session included the left lung, with instillation of the physiological solution at 37  C in 500 ml aliquots up to 16 L, to determine the moment when the effluent becomes clear (Fig. 3).