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March 2013 imaging case of the month

Keywords: pulmonary alveolar proteinosis , crazy paving , linear opacities , reticular opacities , ground glass , bronchoalveolar lavage , PAS positive , granulocyte-macrophage stimulating factor , whole lung lavage , rituximab

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Abstract:

No abstract available. Article truncated after first page. Clinical History: A 54-year old Hispanic woman with no significant past medical history presented with complaints of cough and worsening dyspnea. She was in her usual state of health until 4-5 weeks prior to presentation when she started noticing gradually worsening dyspnea on exertion. She reported a dry cough initially which subsequently became productive of whitish, mucoid sputum. The patient denied chest pain, sore throat, sick contacts, or recent travel history. A chest x-ray was performed (Figure 1). Which of the following statements regarding the chest radiograph is most accurate?1.The chest radiograph shows bilateral linear and reticular abnormalities 2.The chest radiograph shows nodular interstitial thickening 3.The chest radiograph shows multiple, bilateral circumscribed nodules 4.The chest radiograph shows mediastinal and hilar lymph node enlargement 5.The chest radiograph shows mediastinal widening

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