2020 Volume 34 Issue 7 Pages 751-756
A 71-year-old woman had been diagnosed with autoimmune pulmonary alveolar proteinosis 4 years prior to presentation at our department. Chest computed tomography (CT) showed a lung nodule with cavitation in the right upper lobe, with typical CT findings of pulmonary alveolar proteinosis disappearing gradually. We suspected that the nodule was lung cancer and decided to perform surgery. The operative procedure was right upper lobectomy and lymph node dissection via complete video-assisted thoracic surgery (VATS). The pathological diagnosis was pT1cN0M0, pStage IA3, adenosquamous carcinoma. The pulmonary alveolar proteinosis was not exacerbated during the perioperative period. Pulmonary alveolar proteinosis is a rare pulmonary disease characterized by excessive alveolar accumulation of surfactant due to defective alveolar clearance by macrophages. Patients positive for anti-granulocyte-macrophage colony-stimulating factor antibody are categorized as having autoimmune pulmonary alveolar proteinosis. There are only a few published case reports of autoimmune pulmonary alveolar proteinosis occurring in association with lung cancer. To our knowledge, this is the first case report of autoimmune pulmonary alveolar proteinosis associated with lung adenosquamous carcinoma. Autoimmune pulmonary alveolar proteinosis may be involved in lung cancer development and mycobacterial infection.
