Diagnosis and management of alveolar proteinosis: the role of electron microscopy.

Ultrastructural examination of broncho-alveolar lavage for diagnosis of pulmonary histiocytosis X: Preliminary report on 4 cases.

“…Alveolar lavage has been used effectively for diagnosis in bronchiolo-alveolar carcinoma (Dobbins et al, 1973), in alveolar proteinosis (Costello et al, 1975), and in pulmonary infections caused by opportunistic organisms (Finley et al, 1967 (Wolff, 1972;Basset et al, 1976).…”

Particle-induced Pulmonary Alveolar Proteinosis and Subsequent Inflammation and Fibrosis: A Toxicologic and Pathologic Review

“…It is presently taken as certain that surfactant is a major component of the PAP material, which is produced by overproduction by alveolar type II epithelial cells and/or a disturbed removal process by type II cells and alveolar macrophages (Seymour and Presneill 2002). Electron microscopy has also revealed, apart from amorphous material, accumulation of myelin-like, multilamellar bodies in PAP (Costello et al 1975;Gilmore, Talley, and Hook 1988;Maygarden et al 2001;Wasserman and Mason 1994;Yi et al 2012). Depending on the degree of severity, this accumulated material leads to an impairment of gas exchange (Briens et al 2002;Inoue et al 2008).…”

Development of Treatment for Pulmonary Alveolar Proteinosis

“…They described the histological appearance of slight interstitial inflammation and the marked periodic acid Schiff (PAS)-positive proteinaceous alveolar deposits, whichwere confirmed as alveolar accumulation of the componentsof pulmonarysurfactant morphologically, immunologically, and biochemically (2)(3)(4)(5). In addition, serum levels of surfactant protein (SP)-A and -D, components of the accumulated surfactant, are quite high possibly because of their leakage from alveolar spaces to bloodstream (5,6).…”