Nosaka Seishi, Murayama Masaki, Morita Katsuhiko, Katsuda Kou
Department of Surgery, Iwakuni Minami Hospital, Iwakuni, Japan.
Kyobu Geka. 2011 Feb;64(2):139-41.
A 74-year-old woman was admitted to our hospital for further examination of chest X-ray abnormality. The chest computed tomography (CT) revealed a nodular lesion (1.0 cm in diameter) in right lung. Bronchoscopic biopsy showed no malignant cells and bronchoalveolar lavage fluid was not milky white. We performed video-assisted thoracic surgery and a tumor was resected. Histologically, dilated alveolar areas was filled with eosinophilic materials. This finding was compatible with pulmonary alveolar proteinosis (PAP). The characteristic CT finding of PAP is ground glass opacities in both lungs with thickened alveolar septa (so-called crazy-paving appearance). The CT findings of this case (unilateral, single nodular lesion) are very rare, so we report this case with references to the literatures.
一名74岁女性因胸部X线异常入院进一步检查。胸部计算机断层扫描(CT)显示右肺有一个结节性病变(直径1.0厘米)。支气管镜活检未发现恶性细胞,支气管肺泡灌洗液也不是乳白色。我们进行了电视辅助胸腔镜手术并切除了肿瘤。组织学检查显示,扩张的肺泡区域充满嗜酸性物质。这一发现符合肺泡蛋白沉积症(PAP)。PAP的特征性CT表现是双肺磨玻璃影伴肺泡间隔增厚(所谓的铺路石样表现)。该病例的CT表现(单侧、单个结节性病变)非常罕见,因此我们结合文献报道此病例。