Chest
Volume 95, Issue 2, February 1989, Pages 466-467
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Pulmonary Alveolar Proteinosis: Occurrence with Metastatic Melanoma to Lung

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Pulmonary alveolar proteinosis is characterized by excessive accumulation of surfactant-like material in the alveoli, resulting in part from defective alveolar clearance by macrophages. We present a case of alveolar proteinosis in a patient with malignant melanoma metastatic to lung and discuss possible alteration in macrophage function in the pathogenesis of these two concomitant processes.

(Chest 1989; 95:466-67)

Section snippets

CASE REPORT

A 24-year-old man was referred to our institution for management of malignant melanoma. He had developed a nodular lesion over the right scapula several months after sustaining local trauma. When initially seen by the referring physician, the patient reported significant recent weight loss attributed to loss of appetite and poor eating habits. He had a 20 pack-year smoking history with stable chronic cough and a seizure disorder, which was controlled by primidone and carbamazepine. He had no

DISCUSSION

Pulmonary alveolar proteinosis (PAP) is characterized by excess accumulation of a surfactant-like material in the alveoli, resulting in part from defective alveolar clearance by macrophages. PAP has been described as an isolated process, in conjunction with a variety of inflammatory conditions such as infection and silicosis, and with hematologic malignancies of the immune or hematopoetic systems, including leukemia, lymphoma, and blood dyscrasias.1-3

In many of these conditions, defective or

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    Silica) and immune deficiency syndromes. There have been only five sporadic case reports associated with solid organ cancers, including one mesothelioma [3], two primary squamous cell carcinoma of the lung in males [4,5], one gliobastoma [6], and one metastatic pulmonary melanoma [7]. In contrast, our cases were both females with adenocarcinoma.

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