Bronchoalveolar lavage fluid showing numerous amorphous debris

Introduction In patients with alveolar proteinosis, fiberoptic bronchoscopy biopsy, pathological examination showed that the alveolar cavity was filled with PAS-positive coarse granular material, and alveolar lavage fluid showed a large number of amorphous fragments, often accompanied by PAS-positive macrophages.

Cause

The cause is unknown, and it is speculated to be related to several factors: such as a large amount of dust inhalation (aluminum, silica, etc.), decreased immune function (especially infants and young children), genetic factors, alcoholism, microbial infections, etc. For infections, it is sometimes difficult to confirm whether it is a primary pathogenic factor or secondary to alveolar proteinosis. For example, cytomegalovirus, Pneumocystis carinii, histoplasmosis infection, etc. are found to have high protein deposition in the alveoli.

an examination

Related inspection

Chest flat chest perspective

Chest X-rays can be characterized by diffuse nodules, patchy shadows or large solid shadows, and HRCT can be characterized by "map-like" or "paving stone". Fiberoptic bronchoscopy biopsy, pathological examination showed that the alveolar cavity was filled with PAS-positive coarse granular material, and alveolar lavage fluid showed a large number of amorphous fragments, often accompanied by PAS-positive macrophages.

Differential diagnosis

Alveolar proteinosis is non-specific and should be differentiated from:

1 idiopathic pulmonary interstitial fibrosis.

2 alveolar cancer.

3 miliary tuberculosis.

4 lung substantive diseases such as viral pneumonia, mycoplasma pneumonia and chlamydia pneumonia.

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