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Pulmonary Alveolar Proteinosis Versus Pulmonary Edema

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Practical Lung Pathology

Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

Pulmonary alveolar proteinosis (PAP) and pulmonary edema are both acute to subacute pulmonary conditions that result in bilateral hazy opacities on chest X-ray and ground-glass opacities on chest computed tomography (CT). However, pulmonary edema is typically secondary to an underlying illness or condition such as congestive heart failure, while PAP is an autoimmune in nature in greater than 90% of cases. On histopathology, pulmonary edema can resemble PAP due to the presence of frothy, eosinophilic material within alveolar spaces. However, PAP can be readily distinguished by cytology or surgical biopsy based on the features including the periodic acid-Schiff (PAS)-positive nature of the proteinaceous material, lack of inflammatory infiltrate, and presence of cholesterol clefts. Distinguishing these two entities is important due to their vastly different treatment regimens with PAP requiring whole lung lavage in moderate to severe cases versus the use of diuretics and treatment of the underlying conditions in pulmonary edema.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Karen E. Trevino

  2. Weill Cornell Medicine, Department of Pathology and Laboratory Medicine, New York, NY, USA

    Chen Zhang

Authors
  1. Karen E. Trevino
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  2. Chen Zhang
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Corresponding author

Correspondence to Chen Zhang .

Editor information

Editors and Affiliations

  1. Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA, USA

    Haodong Xu

  2. Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA, USA

    Robert W. Ricciotti

  3. Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA, USA

    Jose G. Mantilla

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Trevino, K.E., Zhang, C. (2022). Pulmonary Alveolar Proteinosis Versus Pulmonary Edema. In: Xu, H., Ricciotti, R.W., Mantilla, J.G. (eds) Practical Lung Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-031-14402-8_45

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  • DOI: https://doi.org/10.1007/978-3-031-14402-8_45

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-14401-1

  • Online ISBN: 978-3-031-14402-8

  • eBook Packages: MedicineMedicine (R0)

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