Alveolar proteinosis (Figures 27, 133) is a rare lung disorder, whereby the alveoli are filled with protein-rich secretions (surfactant). Treatment, in patients suffering from persistent respiratory symptoms, involves repeated bronchioalveolar lavage (BAL). There is no curative treatment. The CT picture, involving widespread crazy paving, is highly characteristic.
Figure 133. 40-year-old man with long-standing alveolar proteinosis. A and B show typical crazy paving (ground-glass and extensive reticular pattern). Note the absence of fibrosis.