skip to main content

Pulmonary alveolar proteinosis — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardImagingPulmonary alveolar proteinosisSCE Respiratory

A 42-year-old man develops progressive breathlessness and cough with milky bronchoalveolar lavage fluid. HRCT shows bilateral ground-glass opacities with superimposed interlobular septal thickening, creating a polygonal pattern. He has no heart failure, and autoimmune testing is negative. Serum GM-CSF antibodies are positive. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Pulmonary alveolar proteinosis

Crazy-paving on HRCT with milky lavage and GM-CSF antibodies indicates autoimmune pulmonary alveolar proteinosis. Pulmonary oedema can create septal thickening, but positive GM-CSF antibodies and lavage appearance are decisive. Whole-lung lavage remains a specialist treatment for symptomatic disease.

Reference: ERS pulmonary alveolar proteinosis statement; Fleischner imaging glossary