Secondary pulmonary alveolar proteinosis associated with myelodysplastic syndrome

Intern Med. 2003 Feb;42(2):187-90. doi: 10.2169/internalmedicine.42.187.


A 47-year-old man, who had been diagnosed as myelodysplastic syndrome (MDS), complained of a severe cough and a high-grade fever. Chest CT disclosed scattered small nodules and ground-glass opacities with interlobular septal thickening in both lung fields and a mass lesion in the right lower lobe. Pathological findings of the ground-glass opacities and the mass lesion obtained by video-assisted thoracoscopic surgery revealed the accumulation of eosinophilic amorphous material in the alveoli and confirmed the diagnosis of pulmonary alveolar proteinosis (PAP). Autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF) in sera were below sensitivity, while the GM-CSF level was elevated in bronchoalveolar lavage fluid. He was diagnosed as secondary PAP associated with MDS.

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Needle
  • Blotting, Western
  • Bronchoalveolar Lavage Fluid / cytology
  • Disease Progression
  • Fatal Outcome
  • Granulocyte-Macrophage Colony-Stimulating Factor / analysis*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / complications*
  • Myelodysplastic Syndromes / diagnosis*
  • Pulmonary Alveolar Proteinosis / complications*
  • Pulmonary Alveolar Proteinosis / diagnosis*
  • Risk Assessment


  • Granulocyte-Macrophage Colony-Stimulating Factor