title: Autoimmune pulmonary alveolar proteinosis co-existing with breast cancer: a case report.
abstract: BACKGROUND
  Pulmonary alveolar proteinosis is a rare pulmonary disease characterized by excessive alveolar accumulation of surfactant due to defective alveolar clearance by macrophages. There are only a few published case reports of pulmonary alveolar proteinosis occurring in association with solid cancers. To the best of our knowledge, there are no previously reported cases of pulmonary alveolar proteinosis associated with breast cancer.
  
  
  METHODS
  A 48-year-old Asian woman, a nonsmoker, presented to our institution with a right breast mass. Biopsy examination of the lesion revealed scirrhous carcinoma. A chest computed tomography scan for metastases showed abnormal shadows in both upper lung fields. As a result of flexible fiberscopic bronchoscopy, this patient was diagnosed as having pulmonary alveolar proteinosis. This case was categorized as autoimmune pulmonary alveolar proteinosis due to the positive anti-granulocyte-macrophage colony-stimulating factor antibody. Pulmonary alveolar proteinosis decreased gradually after mastectomy.
  
  
  CONCLUSIONS
  The present case involved the coincident occurrence of autoimmune pulmonary alveolar proteinosis with breast cancer; breast cancer may be a factor during pulmonary alveolar proteinosis development.
authors.affiliation: Department of Respiratory Medicine, Nagasaki Harbor Medical Center City Hospital, 6-39 Shinchi-machi, Nagasaki 850-8555, Japan. toyosawai@yahoo.co.jp.
authors.forename: Toyomitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Umeyama
authors.forename: Sumako
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Nobuko
authors.initials: N
authors.lastname: Matsuo
authors.forename: Naofumi
authors.initials: N
authors.lastname: Suyama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D011649:Pulmonary Alveolar Proteinosis / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D016217:Ultrasonography, Mammary