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Naveed Haroon Rashid, Saba Farooq, Mohammad Ahmed, Ali Bin Sarwar Zubairi
Pulmonary alveolar proteinosis (PAP) is a rare lung disease where periodic acid Schiff (PAS)-positive eosinophilic material accumulates in the alveoli of the lungs. Here we describe two cases of young males who presented with dynpnoea and weight loss. The HRCT scan of the chest in both cases showed the typical "crazy-paving" pattern and lung biopsies confirmed the diagnosis of PAP. They showed remarkable symptomatic improvement with therapeutic whole lung lavage.
May 2017: JPMA. the Journal of the Pakistan Medical Association
Rafael Martínez-Girón, Santiago Martínez-Torre
The simultaneous presentation of two noninflammatory pulmonary diseases, pulmonary alveolar proteinosis and Kaposi's sarcoma (Ks), in an HIV-infected patient, is described. A 29-year-old black race patient was admitted to the hospital because of general malaise, weight loss, dyspnea, chest pain, and cough with hemoptoic expectoration. Chest X-rays revealed a patchy bilateral alveolar pattern with a tendency toward the formation of condensations. The serological test revealed HIV positivity (CD4 counts of 393 cells/mm(3))...
April 2017: Annals of Thoracic Medicine
Rajanshu Verma, Mamoun Abdoh
Crazy paving pattern is the name given to characteristic polygonal pattern of interlobular thickening on computed tomography (CT scan) of the lung, which results from accumulation of collagen, interstitial fluid, cell, or other pathology and may be seen in multiple clinical conditions including metastatic cancer as described in this case.
April 2017: Clinical Case Reports
Sabine Dettmer, Viktor Grünwald, Thomas Fuehner, Arnold Ganser, Frank Wacker, Philipp Ivanyi, Thomas Rodt
BACKGROUND: Targeted therapies are the standard treatment in patients with metastatic renal cell carcinoma (mRCC) and are known to cause adverse pulmonary events. Organizing pneumonia (OP) with its various manifestations in computed tomography (CT) has therefore lately received more attention. PURPOSE: To describe the spectrum of CT patterns of OP in patients with mRCC receiving targeted therapies. MATERIAL AND METHODS: Seventeen patients with known therapy-related OP were analyzed retrospectively by two blinded radiologists in consensus...
February 2017: Acta Radiologica Open
Janith Galhenage, Buddhika Weerasinghe, Wadasinghe Dilesha, Roshana Constantine, Bandu Gunasena
BACKGROUND: Pulmonary alveolar proteinosis is a rare disease characterized by accumulation of lipoproteinaceous material within alveoli. There are three clinically distinct forms: congenital, acquired and secondary. Whole lung lavage is currently the gold standard therapy for severe cases of pulmonary alveolar proteinosis. In Sri Lanka this is the first reported successful whole lung lavage for a patient with pulmonary alveolar proteinosis. CASE PRESENTATION: We describe the case of a 15-year-old Sri Lankan girl who presented with symptoms of progressive shortness of breath and dry cough for 6 months' duration...
March 8, 2017: Journal of Medical Case Reports
Yoritake Sakoda, Yojiro Arimori, Masakatsu Ueno, Takafumi Matsumoto
A 39-year-old man treated with dasatinib for chronic myelogenous leukaemia presented to our hospital with haemoptysis, coughing, and dyspnoea. Chest radiography and computed tomography revealed ground-glass opacities and a crazy-paving pattern. Bronchoalveolar lavage was not performed due to serious hypoxemia and bleeding. Significant bleeding from the peripheral bronchi led to a diagnosis of an alveolar haemorrhage. Dasatinib-induced alveolar haemorrhaging was suspected based on the clinical findings. His condition improved immediately after dasatinib withdrawal and initiation of steroid therapy...
2017: Internal Medicine
Hammad Arshad, Meilin Young, Tariq Cheema
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Shahnaz Ul Rehman, Jeffrey R Hammersley
No abstract text is available yet for this article.
November 2016: Mayo Clinic Proceedings
Hidenori Katsumi, Masaki Tominaga, Morihiro Tajiri, Shigeki Shimizu, Yuki Sakazaki, Takashi Kinoshita, Masaki Okamoto, Tomotaka Kawayama, Tomoaki Hoshino
A 66-year-old woman was referred to our hospital for investigation of interstitial lung disease. She had spent most of her time in a shrine, and had always been exposed to vaporized paraffin from burning candles. Chest High-resolution computed tomography (HRCT)showed ground-glass attenuation with thickening of septal lines, wh create the so-called "crazy-paving appearance". Although bronchoalveolar lavage(BAL) and transbronchial biopsy were performed to aid in diagnosis, the findings did not reveal any conclusive information...
2016: Respiratory Medicine Case Reports
Masanori Akira, Yoshikazu Inoue, Toru Arai, Chikatoshi Sugimoto, Sayoko Tokura, Koh Nakata, Masanori Kitaichi
OBJECTIVE: The CT findings of pulmonary fibrosis in patients with pulmonary alveolar proteinosis (PAP) are not yet well defined. The objective of this study was to evaluate the CT findings of PAP with a focus on pulmonary fibrosis secondary to PAP. MATERIALS AND METHODS: High-resolution CT (HRCT) scans of 44 patients with PAP were evaluated retrospectively with a focus on pulmonary fibrosis: 33 patients had autoimmune PAP, and 11 patients had secondary PAP. The intervals between the initial and last CT examinations ranged from 1 to 284 months (median, 60 months)...
September 2016: AJR. American Journal of Roentgenology
Yuki Tenjin, Taiyo Komatsu, Sayuri Hirooka, Kazuyoshi Nakamura, Hideshi Uramoto, Hironori Kobayashi, Fumiya Imamura, Osamu Sakamoto, Mitsuhiro Matsumoto, Takaaki Ito, Hirotsugu Kohrogi
Primary lung tumor tissue exhibiting numerous multinucleated osteoclast-like giant cells (OGCs) is an extremely rare histological type. In this study, we describe the case of an 82-year-old woman. Chest CT demonstrated an extensive crazy-paving appearance in both of the lung fields and a solid round mass in the right lower lobe. A pathological examination of the tumor revealed sarcomatoid carcinoma containing OGCs combined with diffused, invasive lepidic predominant adenocarcinoma. We herein present an extremely rare lung cancer, invasive lepidic predominant adenocarcinoma extensively involving the lung with areas of sarcomatoid carcinoma containing OGCs...
2016: Internal Medicine
Yikuan Feng, Jianping Zhao, Qun Yang, Weining Xiong, Guohua Zhen, Yongjian Xu, Zhenxiang Zhang, Huilan Zhang
BACKGROUND: In the lung, melanoma is mostly arranged as patterns of multiple nodules, solitary nodules, or miliary invasions. Very rarely, it also displays a "crazy paving" pattern (also described as a "paving stone," "flagstone," or "slabstone" pattern), which is rarer still in discrete bilateral nodules. This pattern is considered to be caused by pulmonary alveolar proteinosis, but its association with various diseases is unclear. CASE PRESENTATION: A 60-year-old man was diagnosed with pulmonary melanoma...
2016: BMC Cancer
Ryan R Kroll, Sameer Kumar, Ronald F Grossman, Charles Price, John R Srigley
Pulmonary alveolar proteinosis (PAP) is a rare condition characterized by dysfunctional alveolar macrophages, which ineffectively clear surfactant and typically cause mild hypoxemia. Characteristic Computed Tomography findings are septal reticulations superimposed on ground-glass opacities in a crazy paving pattern, with a clear juxtaposition between affected and unaffected parenchyma. While traditionally PAP was diagnosed via biopsy, bronchoalveolar lavage (BAL) is usually sufficient; the fluid appears milky, and on microscopic examination there are foamy macrophages with eosinophilic granules and extracellular hyaline material that is Periodic Acid-Schiff positive...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
A Beurton, E Gomez, D Mandry, J Champigneulle, P Perez, A Chaouat, F Chabot
INTRODUCTION: The pneumonic form is very characteristic of lepidic pattern adenocarcinoma of the lung. However, the diagnosis and treatment of the disease when it presents in this way may be delayed by atypical radiological findings and severity of hypoxemia. CASE REPORT: A 48-year-old female, non-smoker, asthmatic since the age of 20 years, was hospitalized for a diffuse infiltrative pneumonia complicated by severe respiratory failure. The history included chronic cough, gradually increasing dyspnoea on exertion lasting for 14 months and the onset of haemoptysis of low abundance associated with arthralgia in the previous month...
November 2016: Revue des Maladies Respiratoires
Georgios Antonios Sideris, Maureen Josephson
BACKGROUND: Pulmonary involvement in Niemann-Pick disease (NPD) is a common finding, especially in type B. It usually manifests with symptoms of restrictive lung disease appearing in adulthood but showing gradual deterioration over time. Treatment options have been dramatically limited, with whole lung lavage offering only temporary improvement. Pulmonary alveolar proteinosis (PAP) has been previously mentioned as part of lung disease in NPD, but only in rare cases of type C2. This is the first study that reports the coexistence of autoimmune PAP with NPD type B...
2016: Respiratory Medicine Case Reports
Shekhar Kunal, Kamal Gera, Vikas Pilaniya, Sudhir Jain, Rajesh Gothi, Ashok Shah
No abstract text is available yet for this article.
May 2016: Lung India: Official Organ of Indian Chest Society
Shekhar Kunal, Vikas Pilaniya, Sudhir Jain, Ashok Shah
Organising pneumonia (OP) is a distinct but uncommon entity with characteristic clinicoradiological features and histological findings. When the aetiology of OP remains unknown, it is termed as cryptogenic OP (COP). COP is seen in the majority of patients with OP and usually observed in non/former smokers. A 54-year-old man, a smoker, presented with breathlessness, cough and mucoid sputum. Imaging demonstrated unilateral 'Crazy-paving' pattern in the left upper lobe and left-sided effusion. In addition, paraseptal emphysema and left lower lobe bullae along with very severe obstructive ventilatory defect and impaired diffusion suggested chronic obstructive pulmonary disease (COPD)...
May 6, 2016: BMJ Case Reports
Vikas Pilaniya, Shekhar Kunal, Sudhir Jain, Ashok Shah
No abstract text is available yet for this article.
2016: Permanente Journal
Bruno Hochhegger, Roberto Schumacher Neto, Edson Marchiori
No abstract text is available yet for this article.
January 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Marco Piolanti, Giorgia Dalpiaz, Mariano Scaglione, Carlo Coniglio, Marco Miceli, Sara Violini, Rocco Trisolini, Libero Barozzi
OBJECTIVE: The purpose of this study was to evaluate the lung computed tomography (CT) findings in fat embolism (FE) syndrome. METHODS: We retrospectively evaluated 19 CT examinations of 18 patients with FE syndrome, diagnosed clinically using the Gurd and Wilson criteria. RESULT: Fat embolism syndrome showed 3 patterns: negative examination, bilateral interstitial-alveolar involvement, and adult respiratory distress syndrome like. Frequent findings included consolidations (17 patients), mostly with gravity dependent distribution, and ground-glass opacities (17 patients), mostly with patchy distribution...
May 2016: Journal of Computer Assisted Tomography
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