title: Secondary pulmonary alveolar proteinosis associated with myelodysplastic syndrome.
abstract: 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.
authors.affiliation: Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ohnishi
authors.forename: Gen
authors.initials: G
authors.lastname: Yamada
authors.forename: Noriharu
authors.initials: N
authors.lastname: Shijubo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takagi-Takahashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Itoh
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Satoh
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koba
authors.forename: Koh
authors.initials: K
authors.lastname: Nakata
authors.forename: Shosaku
authors.initials: S
authors.lastname: Abe
mesh_terms: 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
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor