Taniguchi Hirokazu, Abo Hitoshi, Touge Masayoshi, Shinnou Hideki, Miyazawa Hideki, Noto Hirofumi, Uchiyama Akio, Miwa Atsuo, Shimura Shoetsu, Izumi Saburo
Department of Internal Medicine, Toyama Prefectural Central Hospital.
Arerugi. 2008 Aug;57(8):1061-6.
A 58-year-old Japanese female consulted our staff with multiple localized ground-glass opacities in chest CT. She underwent video assisted thoracoscopic surgery for diagnosis. Histopathologic finding from surgery specimen in one of ground-glass opacities revealed bronchioloalveolar carcinoma. Six months later, we performed second video assisted thoracoscopic surgery, and histopathologic finding of all other ground-glass opacities revealed pulmonary alveolar proteinosis. Serum anti GM-CSF antibody elevated, and she was diagnosed as having idiopathic pulmonary alveolar proteinosis. A case of idiopathic pulmonary alveolar proteinosis presenting multiple localized ground-glass opacities is rare. And, differentiating ground-glass opacities of pulmonary alveolar proteinosis and bronchioloalveolar carcinoma by chest CT is difficult.
一名58岁的日本女性因胸部CT发现多处局限性磨玻璃影前来我院就诊。她接受了电视辅助胸腔镜手术以明确诊断。其中一个磨玻璃影手术标本的组织病理学检查显示为细支气管肺泡癌。6个月后,我们进行了第二次电视辅助胸腔镜手术,所有其他磨玻璃影的组织病理学检查显示为肺泡蛋白沉积症。血清抗GM-CSF抗体升高,她被诊断为特发性肺泡蛋白沉积症。特发性肺泡蛋白沉积症表现为多处局限性磨玻璃影的病例较为罕见。而且,通过胸部CT鉴别肺泡蛋白沉积症和细支气管肺泡癌的磨玻璃影很困难。