title: A case of secondary pulmonary alveolar proteinosis, but prior to myelodysplastic syndrome.
abstract: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder. We herein report the first case of PAP that happened 2 years before myelodysplatic syndrome (MDS). A 34-year-old Chinese presented with a developed recurrent cough and shortness of breath. Computed tomography scan disclosed ground-glass opacities with interlobular septal thickening. Histological examination showed eosinophilic dense homogenous material filling in the alveolar. This precipitate had a fine granular appearance. The eosinophilic material was periodic acid-Schiff reaction-positive. The patient was diagnosed with PAP. Two years later he was admitted to a hospital because of dizziness of 1-month duration. Hematological examination showed white blood cells was 2700, hemoglobin was 7.4 g/dL, and platelet count was 21,000 platelets/mm(3). Following bone marrow biopsy and histopathologic examination, he was diagnosed with MDS with refractory anemia and excess blasts. So for PAP patients, follow-up tests should be considered in order to find any possible underlying disease.
authors.affiliation: Department of Respiratory Disease, Shanghai Pudong New Area Gongli Hospital Shanghai, China.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Disease, Shanghai Pudong New Area Gongli Hospital Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Institute of Respiratory Medicine, Xinqiao Hospital, Third Military Medical University Chongqing, China.
authors.forename: Xueling
authors.initials: X
authors.lastname: Wu
keywords: Myelodysplastic syndrome; secondary pulmonary alveolar proteinosis