Pulmonary alveolar proteinosis versus exogenous lipoid pneumonia showing crazy-paving pattern: Comparison of their clinical features and high-resolution CT findings

Choi, Hei Kyung; Park, Chang Min; Goo, Jin Mo; Lee, Hyun Ju

doi:10.3109/02841850903575332

Cited by 14 publications

(20 citation statements)

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“…(pct. a )ReferencesPulmonary alveolar proteinosis203(44.42 %) Pulmonary alveolar proteinosis24Luo, J., et al (2014) [16]35Mehrian, P., et al (2014) [9]14Souza, C. A., et al (2012) [17]15Ishii, H., et al (2009) [18]8Choi, H. K., et al (2010) [19]6Spira, D., et al (2013) [20]6Cai, X., et al (2005) [21]5Coulier, B., et al (1999) [22]5Johkoh, T., et al (1999) [14]3Ishii, H., et al (2009) [18]3Mu, X. D., et al (2008) [23]3Akin, M. R. and G. K. Nguyen (2004) [24]2Oh, S. J., et al (2014) [25]2Luo, J., et al (2013) [26]1Choi, Y. R., et al (2015) [27]1Oda, N., et al (2015) [28]1Kinehara, Y., et al (2014) [29]1Albores, J., et al (2013) [30]1Moisan, M., et al (2013) [31]1Langwieler, S., et al (2012) [32]1Jayaraman, S., et al (2010) [33]1Maimon, N. and D. Heimer (2010) [34]1Ueda, Y., et al (2009) [35]1McDermott, H., et al (2009) [36]1Matsunaga, K., et al (2008) [37]1Sugimoto, C., et al (2006) [38]1De Arriba, C., et al (2006) [39]...…”

Section: Discussionmentioning

confidence: 99%

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

et al. 2016

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BackgroundIn the lung, melanoma is mostly arranged as patterns of multiple nodules, solitary nodules, or miliary invasions. Very rarely, it also displays a “crazy paving” pattern (also described as a “paving stone,” “flagstone,” or “slabstone” pattern), which is rarer still in discrete bilateral nodules. This pattern is considered to be caused by pulmonary alveolar proteinosis, but its association with various diseases is unclear.Case presentationA 60-year-old man was diagnosed with pulmonary melanoma. Computed tomography revealed discrete bilateral nodules surrounded by a “paving” pattern. A literature review found more than 40 types of diseases that have presented with “paving” patterns in the lung—predominantly pulmonary alveolar proteinosis, viral pneumonia, exogenous lipoid pneumonia, bacterial pneumonia, pulmonary alveolar microlithiasis, interstitial pneumonia, ARDS, squalene aspiration pneumonia, radiation pneumonitis, drug-induced pneumonitis, pulmonary leptospirosis, pulmonary hemorrhage, and pulmonary nocardiosis.ConclusionsWe describe the first case of pulmonary melanoma in the form of discrete bilateral nodules accompanied with a computed tomography paving pattern. Although pulmonary paving patterns are rare, more than 40 diseases reportedly display them; clinicians should consider melanoma of the lung in differential diagnoses for patients who show such a pattern.

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Section: Discussionmentioning

confidence: 99%

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

et al. 2016

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“…When the airspaces adjacent to the inter-and intralobular septa and to the alveolar walls fill, the periacinar pattern becomes visible (Fig. 2c) [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

The crazy-paving pattern: a radiological-pathological correlation

et al. 2011

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The crazy-paving pattern is a linear pattern superimposed on a background of ground-glass opacity, resembling irregularly shaped paving stones. The crazy-paving pattern is initially described as the pathognomonic sign of alveolar proteinosis. Nowadays this pattern is a common finding on high-resolution CT imaging, and can be seen in a number of acute and chronic diseases. The purpose of this paper is to illustrate different diseases that cause this crazy-paving pattern and to correlate the radiological findings from computed tomography with the histopathological findings.

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“…In terms of HRCT, distinctive features that favour lipoid pneumonia over alveolar proteinosis are the presence of ill-defined centrilobular nodules and the coexistence of consolidation [28]. Transbronchial biopsy, bronchoalveolar lavage and a history of oil ingestion are usually diagnostic for ELP.…”

Section: Hrct Patternsmentioning

confidence: 99%

Mimics in chest disease: interstitial opacities

Oikonomou

Prassopoulos

2012

Insights Imaging

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Septal, reticular, nodular, reticulonodular, ground-glass, crazy paving, cystic, ground-glass with reticular, cystic with ground-glass, decreased and mosaic attenuation pattern characterise interstitial lung diseases on high-resolution computed tomography (HRCT). Occasionally different entities mimic each other, either because they share identical HRCT findings or because of superimposition of patterns. Idiopathic pulmonary fibrosis (IPF), fibrosis associated with connective tissue disease, asbestosis, end-stage sarcoidosis or chronic hypersensitivity pneumonitis (HP) may present with lower zone, subpleural reticular pattern associated with honeycombing. Lymphangiomyomatosis may be indistinguishable from histiocytosis or extensive emphysema. Both pulmonary oedema and lymphangitic carcinomatosis may be characterised by septal pattern resulting from thickened interlobular septa. Ill-defined centrilobular nodular pattern may be identically present in HP and respiratory bronchiolitis–associated with interstitial lung disease (RBILD). Sarcoidosis may mimic miliary tuberculosis or haematogenous metastases presenting with miliary pattern, while endobronchial spread of tuberculosis may be indistinguishable from panbronchiolitis, both presenting with tree-in-bud pattern. Atypical infection presenting with ground-glass mimics haemorrhage. Ground-glass pattern with minimal reticulation is seen in desquamative interstitial pneumonia (DIP), RBILD and non-specific interstitial pneumonia (NSIP). Obliterative bronchiolitis and panlobular emphysema may present with decreased attenuation pattern, while obliterative bronchiolitis, chronic pulmonary embolism and HP may manifest with mosaic attenuation pattern. Various mimics in interstitial lung diseases exist. Differential diagnosis is narrowed based on integration of predominant HRCT pattern and clinical history.Teaching Points• To learn about the different HRCT patterns, which are related to interstitial lung diseases.• To be familiar with the more “classical” entities presenting with each HRCT pattern.• To discuss possible overlap of different HRCT patterns and the more common mimics in each case.• To learn about some clues that help differentiate the various diagnostic mimics on HRCT.

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Pulmonary alveolar proteinosis versus exogenous lipoid pneumonia showing crazy-paving pattern: Comparison of their clinical features and high-resolution CT findings

Abstract: PAP and ELP with the crazy-paving pattern have several distinctive characteristics with respect to their HRCT findings as well as history of oil ingestion, and can therefore be distinguished from one another.

Cited by 14 publications

References 20 publications

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

The crazy-paving pattern: a radiological-pathological correlation

Mimics in chest disease: interstitial opacities

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