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Weekly Chest CasesArchive of Old Cases

Case No : 624 Date 2009-10-11

  • Courtesy of Jin Kyoung Kim, Semin Chong, Jae Seung Seo / Department of Radiology, Chung-Ang University Hospital
  • Age/Sex 59 / M
  • Chief ComplaintDyspnea on exertion for 4months.
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Pulmonary alveolar proteinosis
Radiologic Findings
Chest PA shows pericardiac consolidations in both lungs.
Lung setting images of the chest CT images show multisegmental ground-glass attenuation with internal interlobular septal thickening in the subpleural or peribronchial portion of both lungs.
On the basis of CT findings, pulmonary alveolar proteninosis is highly suspected. So bronchoscopy and bronchoalveolar lavage were done. There was turbid fluid material with strongly positive PAS stain in the anterior segment of right upper lobe, consistent with pulmonary alveolar proteinosis(Fig 1). There was irregular elevated mucosal lesion in the posterior wall of left upper lobar brochus. Endobronchial biopsy confirmed the lesion as squamous cell carcinoma(Fig 2), which was not found on chest CT scan. LUL lobecotmy was done.

Fig 1

Fig 2

Brief Review
Please refer to
Case 198, Case 275, Case 404, Case 505, Case 525,
References
Keywords
Lung, Metabolic and storage lung disesae,

No. of Applicants : 116

▶ Correct Answer : 81/116,  69.8%
  • - Assam Medical College , India Pramod K.G
  • - Assam medical college , India Karunakaran M
  • - KING KHALID UNIVERSITY HOSPITAL RADIOLOGY DEPARTMENT , Saudi Arabia elbagir nasser
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - MD SKNMC & GH,Pune,Maharashtra, INDIA , India Sushant Bhadane
  • - DCA, , India Rajesh Gothi
  • - Father Muller Medical College , Mangalore , India nabil mahmood
  • - Dong-A university hospital , Korea (South) Sang-yun LEE
  • - HOSPITAL SOTIRIA , Greece AIKATERINI DELAVERI
  • - NTUH , Taiwan Kuei-pin Chung
  • - McGill University Health Centre , Canada Amr Ajlan
  • - CHRU Lille , France guillaume lefebvre
  • - CHRU Lille , France Benjamin Damarey
  • - Trakya University School of Medicine, Turkey , Turkey Ahmet POLAT
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Mackay Memorial Hospital , Taiwan Sheng-Yeh Shen
  • - Osaka University , Japan Osamu Honda
  • - Busan Paik hospita, inje medical college , Korea (South) Hye Jin Baek
  • - Samsung Medical Center , Korea (South) Ju Won Lee
  • - POPOVO HOSPITAL , Bulgaria VLADISLAV RUSINOV
  • - hospital Sao Paulo , Brazil israel missrie
  • - CHRU lille , France manuel toledano
  • - National Taiwan University Hospital, YL branch , Taiwan Chin-Chung Shu
  • - Samsung Medical Center , Korea (South) Hye Sun Hwang
  • - KKUH , Saudi Arabia raees ahmed
  • - fudan , China ziqiang zhang
  • - Louisiana State University - Shreveport , United States Carlos Previgliano
  • - Seoul St Mary , Korea (South) Jin Kyoung Oh
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
  • - Toyama University Hospital, Laboratory of Pathology , Japan TANAKA TOMONORI
  • - CHU Nancy , France, Metropolitan Guillaume LUX
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - EKH-Berlin , Germany Michael Weber
  • - aarthi scans , India abirami mahadevan
  • - Samsung Medical Center , Korea (South) Eun Kim
  • - Retd. Prof Thoracic Surgery B.J.MEDIDCAL COLLEGE Punr India , India Bankim Amin
  • - Kangnam Sacred Heart Hospital , Korea (South) Jaewon Kim
  • - Soonchunhyang university hospital, Bucheon , Korea (South) ALEUM LEE
  • - NMC hospital Dubai , United Arab Emirates vickrant malhotra
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - SMC , Korea (South) Jihoon Cha
  • - Teleradiology solutions , India harish bhambore
  • - Assam Medical college , India samudra borah
  • - barnard institute of radiology , India jithika prem
  • - Shinsegye Rad Clinic, Daegu , Korea (South) Gi Beom Kim
  • - Seoul National University Hospital , Korea (South) Hye Jin Yoo
  • - Institute of Chest Diseases,Calicut , India sijith raghavan
  • - vinayaka missions medical college , India k bhaskar
  • - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Hospital M de Deus , Brazil Thiago Bento da Silva
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - chp st martin , France Mariotte benoit
  • - CHU caen , France nicolas gautier
  • - private hospital , Turkey pelin tlu
  • - CHUV , Switzerland ANNE-SOPHIE KNOEPFLI
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Trakya University School of Medicine , Turkey Umut Ugur
  • - CH Macon , France sebastien LARIVE
  • - Seoul Nationial University Bundang Hospital , Korea (South) Kyoung Jin Oh
  • - Radiologie Centrale CHU Saint Etienne , France Romain MALEZIEUX
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Hopital du SacrCoeur , Canada Abraham Bohadana
  • - Apollo Gleneagles hosp kolkata , India SALIM PARVEZ
  • - partner, aditya imaging centre , India vivek patel
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - CH Sud Rnion , Reunion jean-baptiste Noel
  • - Armed Force Capital Hospital , Korea (South) Dae Kun Oh
  • - Paramount Diagnostic & Research Centre , India Mahavir Swami
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - NASA SCANS , India RAKESH BHATIA
  • - , Korea (South) Daekeon Lim
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - institute of chest diseases calicut , India divya nair
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - Aba Prefecture People Hospital竊ŒSichuan Maerkang竊Œchina , China pu peng
▶ Correct Answer as Differential Diagnosis : 18/116,  15.5%
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - KMC,Manipal , India satish maddukuri
  • - CHU brest , France, Metropolitan Auffret Mathieu
  • - SMG-SNUH boramae medical center , Korea (South) Kwang Nam Jin
  • - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) YOOKYUNG KIM
  • - CHU GRENOBLE , France g FERRETTI
  • - NOUR EL-ISLAM RADIOLOGY CENTER , Egypt Elsayed Mousa
  • - Saga University , Japan Ryoko Egashira
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - Ruby Hall Clinic , India john joseph
  • - CHR LILLE, France , France Vittorio Pansini
  • - Kashan University of Medical Sciences, kashan , Iran Ebrahim Razi
  • - IRSA , France jean-luc BIGOT
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Cairo University , Egypt Mamdouh Eissa
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - Chungnam national university hospital , Korea (South) Jeoung Eun Lee
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