Unexpected diffuse lung lesions in a patient with pulmonary alveolar proteinosis:A case report  

作　　者：Li Jian Qi-Quan Zhao 

机构地区：[1]Department of Endocrinology,Dazu Hospital of Chongqing Medical University,The People's Hospital of Dazu,Chongqing 402360,China [2]Department of Respiratory and Critical Care Medicine,Dazu Hospital of Chongqing Medical University,The People's Hospital of Dazu,Chongqing 402360,China

出　　处：《World Journal of Clinical Cases》2023年第20期4932-4936,共5页世界临床病例杂志

基　　金：Supported by the Joint Project of Chongqing Health Commission and Science and Technology Bureau,No.2022MSXM103.

摘　　要：BACKGROUND Pulmonary alveolar proteinosis(PAP)often presents nonspecifically and can be easily confused with:(1)Idiopathic interstitial lung fibrosis;(2)alveolar carcinoma;(3)pulmonary tuberculosis;and(4)other lung diseases such as viral pneumonia,mycoplasma pneumonia,and chlamydial pneumonia.CASE SUMMARY Diagnosis:In this case,a patient was diagnosed with PAP through transbronchial cryobiopsy(TBCB)and quantitative metagenomic next-generation sequencing,which confirmed the impairment of surfactant turnover as the underlying cause of PAP.Interventions:High-volume total lung lavage was performed for this patient.Outcomes:The patient's clinical condition had improved significantly by the 6-month follow-up,with a 92%finger oxygen saturation.A repeat chest computed tomography scan revealed scattered patchy ground-glass shadows in both lungs,which was consistent with alveolar protein deposition but with a lower density than in the radiograph from October 23,2022.CONCLUSION TBCB has unique advantages in diagnosing atypical alveolar protein deposition,particularly for enabling the early detection of PAP.This information can help patients take preventive measures to prevent or halt PAP development by avoiding dusty environments and seeking treatment with total lung lavage and inhaled granulocyte macrophage colony-stimulating factor.

关 键 词：Diffuse lung lesions Pulmonary alveolar proteinosis Quantitative metagenomic next-generation sequencing Transbronchial cryobiopsy High-volume double lung 

分 类 号：R563[医药卫生—呼吸系统]