Surgical Pathology Criteria

Pulmonary Alveolar Proteinosis

Differential Diagnosis

Pulmonary edema Pulmonary Alveolar Proteinosis
Smooth appearing fluid Granular fluid with clumping, clefts
Foamy macrophages not prominent Prominent foamy macrophages
Fluid PAS/d negative Fluid PAS/d positive
Anti-GMCSF serology negative Anti-GMCSF serology positive

 

Pneumocystis Pneumonia Pulmonary Alveolar Proteinosis
Bubbly appearing fluid Granular fluid with clumping, clefts
Pneumocystis stains positive Pneumocystis stains negative
Foamy macrophages not prominent Prominent foamy macrophages
Fluid PAS/d negative Fluid PAS/d positive
Anti-GMCSF serology negative Anti-GMCSF serology positive
Infection may be primary or secondary

 

Atypical Mycobacteria Pneumonia Pulmonary Alveolar Proteinosis
Alveolar macrophages more prominent than fluid Prominent fluid with occasional macrophages
Mycobacterial stains positive Mycobacterial stains negative
Anti-GMCSF serology negative Anti-GMCSF serology positive
Infection may be primary or secondary

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