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Lung India Official publication of Indian Chest Society  
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Year : 2020  |  Volume : 37  |  Issue : 4  |  Page : 336-339

Bronchoscopic lung cryobiopsy for the diagnosis of pulmonary alveolar proteinosis in a hypoxemic patient

1 Department of Respiratory Medicine, Military Hospital (CTC), Pune, Maharashtra, India
2 Department of Pathology, Command Hospital (SC), Pune, Maharashtra, India
3 Department of Radiology, Military Hospital (CTC), Pune, Maharashtra, India

Correspondence Address:
Dr. Vikas Marwah
Department of Pulmonary, Critical Care & Sleep Medicine, Military Hospital (CTC), Pune - 411 040, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/lungindia.lungindia_384_19

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Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by the intra-alveolar accumulation of surfactant due to macrophage dysfunction or the production of abnormal surfactant. Diagnosis is usually confirmed by lung biopsy either bronchoscopically or by video-assisted thoracoscopic surgery. Bronchoscopic lung cryobiopsy (BLC) is increasingly being utilized for the histopathological diagnosis of diffuse parenchymal lung diseases; however, it has rarely been reported for PAP. We report a case of 59-year-old male who presented to our center with gradually worsening breathlessness and cough of 1-year duration. Chest radiograph revealed bilateral extensive pulmonary infiltrates and high-resolution computerized tomography scan revealed extensive bilateral ground-glass opacities with areas of sparing. BAL and transbronchial lung biopsy failed to confirm the diagnosis; hence, BLC was done which revealed pathologic findings suggesting PAP. BLC appears to be a promising diagnostic tool for the diagnosis of PAP and offers several diagnostic advantages compared to conventional techniques.

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