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J Thorac Imaging. 2009 May;24(2):115-8. doi: 10.1097/RTI.0b013e3181930ed6.

Secondary pulmonary alveolar proteinosis: a confusing and potentially serious complication of hematologic malignancy.

Author information

1
Department of Radiology, University of Washington Medical Center, Seattle, WA 98195, USA. jchung2@u.washington.edu

Abstract

OBJECTIVE:

We analyzed the computed tomography and clinical findings of pulmonary alveolar proteinosis secondary to hematologic malignancy.

MATERIALS AND METHODS:

Seven patients with hematologic malignancy and pathologically proven secondary pulmonary alveolar proteinosis were identified from 2000 to 2007. Six had chest computed tomography scans, which were analyzed retrospectively; medical records were also reviewed.

RESULTS:

Patient age ranged from 30 to 54 years. Four had chronic myelogenous leukemia, 1 had myelodysplastic syndrome, and 1 had cutaneous T-cell lymphoma. As in idiopathic pulmonary alveolar proteinosis, geographic ground-glass opacities with or without septal thickening were most common (5/6). No axial or zonal predominance was present. Two patients died from respiratory failure.

CONCLUSIONS:

It is important to consider secondary pulmonary alveolar proteinosis as a cause of geographic ground-glass opacities and septal thickening in a patient with hematologic malignancy. Whereas idiopathic pulmonary alveolar proteinosis has a low mortality rate, the death of 2 of our 6 patients implies that secondary pulmonary alveolar proteinosis may have a worse prognosis. Our case of secondary pulmonary alveolar proteinosis associated with cutaneous T-cell lymphoma is the first described in the literature.

PMID:
19465834
PMCID:
PMC2742334
DOI:
10.1097/RTI.0b013e3181930ed6
[Indexed for MEDLINE]
Free PMC Article

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