A Case of Autoimmune Pulmonary Alveolar Proteinosis with Pulmonary Fibrosis and Asbestosis-Like Features
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- NAKAMURA MASAYUKI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- OKAMOTO MASAKI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- FUJIMOTO KIMINORI
- Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine
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- SHIMIZU SHIGEKI
- Department of Pathology, Kindai University Faculty of Medicine
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- TOMINAGA MASAKI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- TSUNEYOSHI SHINGO
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- ZAIZEN YOSHIAKI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- NOUNO TAKASHI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- SAKAMOTO SATOSHI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- KAWAYAMA TOMOTAKA
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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- HOSHINO TOMOAKI
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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<p>Summary: A 78-year-old man who had worked in the building industry visited our hospital because of groundglass opacity with smoothly thickened, intralobular interstitial lines and interlobular septal lines on chest high-resolution computed tomography (HRCT). HRCT image also showed a focal area of reticulation and pleural thickening. Lung specimens obtained by surgical lung biopsy showed accumulations of intra-alveolar periodic acid-Schiffpositive materials, usual interstitial pneumonia (UIP)-like subpleural lung fibrosis and asbestos bodies (1 body/cm2 in high-power field, ×400). Serum granulocyte-macrophage colony stimulating factor autoantibody was positive. The patient was diagnosed as having autoimmune pulmonary alveolar proteinosis (PAP) and needed differential diagnosis from secondary PAP caused from pulmonary asbestosis and UIP. Careful observation of the manifestations of pulmonary asbestosis and the progression of fibrosis using HRCT will be necessary in this patient.</p>
収録刊行物
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- Ｔｈｅ Ｋｕｒｕｍｅ Ｍｅｄｉｃａｌ Ｊｏｕｒｎａｌ
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Ｔｈｅ Ｋｕｒｕｍｅ Ｍｅｄｉｃａｌ Ｊｏｕｒｎａｌ 66 (1), 59-63, 2019-03-31
久留米大学医学部 The Kurume Medical Journal 編集部