A pulmonary alveolar proteinosis (PAP) is a
rare disease characterized by an accumulation of surfactant components in lung
alveoli. A diagnosis of PAP was made on a basis of open lung biopsy which
revealed intraalveolar eosinophilic material with coarse granularity, few
macrophages and lymphocytes. The substance was PAS positive and compatible with
surfactant. The lung interstitial architecture was well preserved with no
lymphocyte infiltration, granuloma or fibrosis of the alveolar septae. The
picture was compatible with PAP. In
diagnosis and monitoring of the disease high resolution computed tomography
(HRCT) is usually used. Unfortunately, repeated exposure to CT scanning may be
associated with an increased risk of radiation. We present a patient in whom
repeated transthoracic lung ultrasonography (TLUS) brought parallel to HRCT
data in assessing PAP extent. It may indicate that TLUS might be potentially a
relevant tool in monitoring of PAP.
