CT scan patterns of pulmonary alveolar proteinosis in children.
BACKGROUND
To study computed tomographic (CT) findings in children with pulmonary alveolar proteinosis (PAP) more extensively.


OBJECTIVE
To describe the CT features at the time of diagnosis and after therapeutic broncho-alveolar lavage (BAL).


METHODS
We retrospectively reviewed the CT scans of five children (aged 3 months to 4 years) examined because of incidental bronchitis (n = 1), disease in a sibling (n = 1) and relapsing fever, cough and dyspnoea (n = 3). Each patient had an initial CT scan. Two asymptomatic cases were not treated but were followed up by plain chest films. The other three had BAL and follow-up CT.


RESULTS
Initial CT in all cases showed a diffuse reticulomicronodular pattern associated in three cases with posterior bilateral alveolar infiltrates. CT in the two asymptomatic patients remained unchanged or slightly improved without BAL. After BAL, a variable decrease of lung infiltrates was observed.


CONCLUSIONS
Correlation between the extent of alveolar consolidation and severity of disease was found. Anatomical and pathological considerations allow us to consider that the classical reticulomicronodular pattern is not due to an interstitial infiltration but to alveoli filled with the abnormal material characteristic of PAP.
Albafouille
V
V
Department of Paediatric Radiology, Hôpital Necker-Enfants Malades, Paris, France.
Sayegh
N
N
De Coudenhove
S
S
Scheinmann
P
P
De Blic
J
J
Mamou-Mani
T
T
Hassine
A
A
Jaubert
F
F
Brunelle
F
F
D001706:Biopsy; D018893:Bronchoalveolar Lavage; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011649:Pulmonary Alveolar Proteinosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed