The case concerns a 65 year old gentleman with a 3 year history of exertional dyspnoea, CT imaging showing crazy paving pattern with peribronchovascular distribution and a Right UL cavitating nodule, mild bronchial wall thickening and mild mediastinal lymph node enlargement.
BAL & serum both show anti-GM CSF positivity, though BAL did not show typical milky fluid.
PAS stain highlights background mucinous material.
The patient’s caring pulmonary physician is requesting assistance whether this fulfils the criteria for diagnosing PAP as well recommendations for treatment once BAL x2 failed to show typical turbid/milky fluid.
BAL & serum both show anti-GM CSF positivity, though BAL did not show typical milky fluid.
PAS stain highlights background mucinous material.
The patient’s caring pulmonary physician is requesting assistance whether this fulfils the criteria for diagnosing PAP as well recommendations for treatment once BAL x2 failed to show typical turbid/milky fluid.
This case is presented by the Mater Dei Hospital National Coordination Hub,ย Malta