1984 Volume 23 Issue 1 Pages 50-56
Sputum, biopsy materials taken from left lung and bronchoalveolar lavage from a patient with pulmonary alveolar proteinosis were studied by light and electron microscopy and electrophoresis.
A 53-year-old male with pneumoconiosis was pointed out the diffuse granular to small nodular shadows on his both lungs by the chest X-ray, which were not improved in spite of the treatement with antituberculosis drugs and other antibiotics. Transbronchial lung biopsy and cytology of sputum were performed, since pulmonary alveolar proteinosis was suspected. Histologic features of the biopsy specimens showed acidophilic and finely granular substance in the alveolar spaces, in which a few macrophages and/or degenerated alveolar epithelia were seen. Other fi ndings were anthracosis, silicotic nodules, squamous metaplasia of bronchial mucosa and infiltration of eosinophils.
Cytologically, numerous eosinophils and Charcot-Leyden crystals and a few mataplastic cells with mild to severe atypism were found in the sputum. In the background, fi nely granular substance, which stained positively by PAS staining, were sparsely observed.
Electron micrographs showed many myelin-like structures and osmiophilic spherical ones. The formers were observed in some parts of the laters, and lamellar bodies originated from type II alveolar epithelia were also surrounded by the myelin-like structures.
Chemical analyses revealed that intraalveolar substance was mainly composed of protein and phospholipid.
