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Alveolar proteinosis with hypersensitivity pneumonitis: a new clinical phenotype
Hema Verma1, Andrew G Nicholson, Keith M Kerr
1Department of Radiology, Royal Marsden Hospital, London, UK.
Background And Objective:
The aim of the present study was to report the features of five patients with concurrent histopathological features of pulmonary alveolar proteinosis (PAP) and hypersensitivity pneumonitis (HP) and their high-resolution CT (HRCT) appearances.
Methods:
Patients with histopathological features of both HP and PAP on surgical lung biopsy referred for tertiary review were retrospectively identified. The pathology and HRCT images were semi-quantitatively scored to evaluate the relative contribution to HP and PAP.
Results:
Five patients had histopathological features of HP and PAP but had varied HRCT appearances. All had imaging features of PAP to a varying degree with two patients also showing characteristics of HP but three patients had ill-defined thickened interlobular septa, not typical of either disease.
Conclusions:
We describe the coexistence of PAP and HP in five patients and discuss possible linkages between these two distinct pathologies.
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