Objective To investigate the clinical features,diagnosis and treatment measures,causes of misdiagnosis and preventive measures of pulmonary alveolar proteinosis(PAP).Methods From January 2020 to June 2023,the clinical data of 4 patients with PAP who had been misdiagnosed and showed atypical ground-glass appearance were retrospectively ana-lyzed.Results In this group,3 cases presented with cough,sputum with or without fever,and 1 case was found to have dif-fuse lesions of both lungs.CT examination of the chest indicated diffuse ground glass appearance.The initial diagnosis was misdiagnosed as pneumonia,and the corresponding treatment was not effective,and the duration of misdiagnosis was 10 d-4 years.All 4 cases were eventually diagnosed as PAP after bronchoalveolar lavage fluid periodic acid-Schiff(PAS)staining.Two cases received large dose of whole lung alveolar lavage,and two cases received symptomatic supportive treatment.They were discharged after improvement.Conclusion PAP is a rare disease,and it is even rarer to have a single large flaker-like ground glass image as the main imaging manifestation.Clinical diagnosis should be made by comprehensive analysis of history,clinical manifestations,imaging manifestations,bronchoscopy,and PAS staining in alveolar lavage.Active treatment usually leads to a good prognosis.
关键词
肺泡蛋白沉积症/中青年/误诊/肺炎/体层摄影术,螺旋计算机/支气管镜/支气管肺泡灌洗/病理检查
Key words
Pulmonary alveolar proteinosis/Young and middle-aged people/Misdiagnosis/Pneumonia/Tomo-graphy,spiral computed/Bronchoscopes/Bronchoalveolar lavage/Pathological examination
维普
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