Secondary pulmonary alveolar proteinosis associated with myelodysplastic syndrome.
A 47-year-old man, who had been diagnosed as myelodysplastic syndrome (MDS), complained of a severe cough and a high-grade fever. Chest CT disclosed scattered small nodules and ground-glass opacities with interlobular septal thickening in both lung fields and a mass lesion in the right lower lobe. Pathological findings of the ground-glass opacities and the mass lesion obtained by video-assisted thoracoscopic surgery revealed the accumulation of eosinophilic amorphous material in the alveoli and confirmed the diagnosis of pulmonary alveolar proteinosis (PAP). Autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF) in sera were below sensitivity, while the GM-CSF level was elevated in bronchoalveolar lavage fluid. He was diagnosed as secondary PAP associated with MDS.
Ohnishi
Tetsuro
T
Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo.
Yamada
Gen
G
Shijubo
Noriharu
N
Takagi-Takahashi
Yoko
Y
Itoh
Takayuki
T
Takahashi
Hiroki
H
Satoh
Masaaki
M
Koba
Hiroyuki
H
Nakata
Koh
K
Abe
Shosaku
S
D001707:Biopsy, Needle; D015153:Blotting, Western; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D018450:Disease Progression; D017809:Fatal Outcome; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000175:diagnosis*; D011649:Pulmonary Alveolar Proteinosis / Q000150:complications* / Q000175:diagnosis*; D018570:Risk Assessment
D016178:Granulocyte-Macrophage Colony-Stimulating Factor