zones. (b) High-resolution CT scan shows diffuse geographic ground-glass attenuation with superimposed intra- and
interlobular septal thickening (arrowhead). Note the polygonal appearance, which represents the secondary pulmonary lobule. (c, d) Photomicrographs (original magnification, 400; hematoxylin-eosin [c] and periodic acid–Schiff
[d] stains) of a specimen from transbronchial biopsy show alveolar spaces filled by a dense, eosinophilic, granular
proteinaceous material () that is positive for periodic acid–Schiff stain.
Rossi, S.E et al “Crazy-Paving” Pattern at Thin-Section CT of the Lungs: RadiologicPathologic Overview Radiographics Volume 23 – Number 6, 2003
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central distribution
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Follow up
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Excellent example of crazy paving
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Source
Signs in Thoracic Imaging
Journal of Thoracic Imaging 21(1):76-90, March 2006.
- Alveolar proteinosis is a rare lung disease.
- It involves the accumulation of proteinaceous material in the alveoli, impairing gas exchange and leading to respiratory failure.
- There are three types: primary, secondary, and congenital.
- Symptoms include shortness of breath, cough, fatigue, weight loss, and chest pain.
- Diagnosis is typically made through imaging studies
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- Diffuse bilateral ground-glass opacities
- “Crazy-paving” appearance
- Thickened interlobular septa and intralobular lines superimposed on ground-glass opacities
- Consolidation may be present, particularly in advanced cases
- Homogeneous opacities involving the upper lobes in primary alveolar proteinosis
- Patchy opacities with peripheral distribution in secondary alveolar proteinosis
- CT findings are non-specific and can resemble other lung diseases, so biopsy is often necessary for diagnosis.
- and a lung tissue biopsy.
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- Treatment may involve whole-lung lavage, medications, or lung transplantation.