Alveolar lipoproteinosis in lung allograft recipients.
Three cases of pulmonary alveolar proteinosis developing in lung allograft recipients are reported. In each case, repeated bouts of alveolar damage from harvest/reperfusion injury, rejection, and infection were observed before the development of intraalveolar accumulation of granular, periodic acid-Schiff-positive material in the allograft lungs. It is speculated that iatrogenic immunosuppression combined with defective clearance of alveolar material by alveolar macrophages created a milieu conducive to the accumulation of surfactant, lipoprotein, and fibrinous debris that was morphologically identical to alveolar proteinosis.
Yousem
S A
SA
Department of Pathology, University of Pittsburgh Medical Center, PA, USA.
D000328:Adult; D004541:Eisenmenger Complex / Q000150:complications / Q000601:surgery; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery; D016041:Heart-Lung Transplantation / Q000009:adverse effects / Q000473:pathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000601:surgery; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011649:Pulmonary Alveolar Proteinosis / Q000209:etiology* / Q000473:pathology*; D014184:Transplantation, Homologous