What is the role of CT scanning in the workup of pulmonary alveolar proteinosis (PAP)?

Updated: Dec 18, 2019
  • Author: Roger B Olade, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

High-resolution computed tomography (HRCT) scanning of the chest demonstrates areas of patchy ground-glass opacification (GGO) with smooth interlobular septal thickening and intralobular interstitial thickening, which produces a polygonal pattern referred to as "crazy paving." The crazy-paving pattern also can be observed in exogenous lipoid pneumonia, sarcoidosis, mucinous bronchoalveolar cell carcinoma, and acute respiratory distress syndrome (ARDS). [30, 31] PAP presenting as ground-glass opacity (GGO) mimics carcinoma. [32] HRCT findings have been able to show several distinctive differences between exogenous lipoid pneumonia and PAP, which had previously only been distinguished pathologically. [33]


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