{"title":"Position-Dependent Lung Shadow Movement.","authors":"Tomohiro Bando, Yumiko Sasaki, Wataru Koike, Kazuko Watanabe, Tadayoshi Hirano, Soei Gen, Mitsuaki Yagi, Daizo Yaguchi, Masato Shizu, Motoshi Ichikawa","doi":"10.1002/rcr2.70139","DOIUrl":null,"url":null,"abstract":"<p><p>A 73-year-old male presented with an abnormal chest x-ray revealing ground-glass opacity (GGO) in the left lower lung field, accompanied by elevated KL-6, SP-D, and GM-CSF antibody levels, indicative of autoimmune pulmonary alveolar proteinosis (PAP). Initial bronchoalveolar lavage and transbronchial lung biopsy revealed only nonspecific findings. During a CT-guided needle aspiration biopsy (CT-NAB), real-time imaging showed that GGO gradually moved and shifted with positional changes. Although PAP is not fully confirmed yet due to a lack of pathological findings, this case highlights several clinical suggestions for patients with atypical lung shadows, including those with suspicion of PAP. Further, this is the first report of lung shadow mobility during CT-NAB, emphasising the need for further studies to elucidate the pathophysiology of lung shadows and improve diagnostic accuracy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 3","pages":"e70139"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868831/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/rcr2.70139","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
A 73-year-old male presented with an abnormal chest x-ray revealing ground-glass opacity (GGO) in the left lower lung field, accompanied by elevated KL-6, SP-D, and GM-CSF antibody levels, indicative of autoimmune pulmonary alveolar proteinosis (PAP). Initial bronchoalveolar lavage and transbronchial lung biopsy revealed only nonspecific findings. During a CT-guided needle aspiration biopsy (CT-NAB), real-time imaging showed that GGO gradually moved and shifted with positional changes. Although PAP is not fully confirmed yet due to a lack of pathological findings, this case highlights several clinical suggestions for patients with atypical lung shadows, including those with suspicion of PAP. Further, this is the first report of lung shadow mobility during CT-NAB, emphasising the need for further studies to elucidate the pathophysiology of lung shadows and improve diagnostic accuracy.
期刊介绍：
Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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