Abstract
A 45-year-old male patient was admitted to our hospital complaining of dyspnea on exertion and palpitation. The chest roentogenogram on first admission showed diffuse acinar shadows throughout total lung fields. Pulmonary alveolar proteinosis (PAP) was diagnosed by transbronchial biopsy (TBLB), which was histologically characterized by the accumlation of PAS-positive proteinaceous material in the alveoli. The patient improved successfully following pulmonary washing.
Three years after onset, he was admitted for the third time complaining of dyspnea on exertion. The chest roentogenogram on its admission showed reduced lung volume and reticular shadows throughout the entire bilateral lung fields. The third TBLB specimen revealed fibrosing alveolitis with intera-alveolar filling of PAS-positive materials. Examination of lymphocyte subsets of broncho-alveolar lavage fluid by monoclonal antibodies revealed abnormal findings of T lymphocyte subsets.
A rare case of pulmonary fibrosing alveolitis following PAP diagnosed by serial lung biopsy was reported. The relation of PAP and fibrosing alveolitis was discussed and it is suggested that fibrosing alveolitis is one clinical stage of PAP.
