en Pulmonology Pulmonology case report case report <p><span style="font-size:14px"><span style="font-family:Times New Roman"><strong><em><span style="color:blue">Background:</span></em></strong> Pulmonary alveolar proteinosis (PAP) is a rare disease caused by the accumulation of surfactant in the lung&#39;s alveoli, as a result of malfunction in the cleaning function of alveolar macrophages. The major symptoms include cough and dyspnea. Computed tomography scan usually reveals crazy-paving pattern. Lung biopsy confirms the diagnosis by showing accumulations of periodic acid-schiff-positive lipoproteinaceous materials.<br> <strong><em><span style="color:blue">Case Presentation: </span></em></strong>In this report, we present a middle-age man with progressive dyspnea on exertion, and frequent cough with no noteworthy medical history. The results of initial examinations and laboratory tests were non-diagnostic, so imaging studies were requested for the patient. After imaging and suspecting PAP as a differential diagnosis due to results of high resolution computed tomography, a transbronchial biopsy was performed to confirm the diagnosis. Then, according to the histopathology reports, the diagnosis of PAP was made. During the biopsy procedure, the patient developed pneumothorax, and accurate treatment approaches were considered for this complication.<br> <strong><em><span style="color:blue">Conclusions:</span></em></strong> In patients with chronic progressive dyspnea and cough, appropriate and timely imaging and other paraclinic investigations must be considered by the physicians.</span></span><br> &nbsp;</p> Pulmonary Alveolar Proteinosis, Biopsy, Surfactant 362 368 http://caspjim.com/browse.php?a_code=A-10-3152-2&slc_lang=en&sid=1 yasaman Sajadi rohanresearch88@gmail.com 100319475328460052308 100319475328460052308 No Clinical Research Development Unit of Rouhani Hospital, Rouhani Hospital, Babol University of Medical Sciences,Babol,IR.Iran Simin Moudi dr.mouodi@gmail.com 100319475328460052309 100319475328460052309 No Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences Babol, Iran Ehsan Chogan ehsan.chogan96@gmail.com 100319475328460052310 100319475328460052310 No Clinical Research Development Unit of Rouhani Hospital, Rouhani Hospital, Babol University of Medical Sciences,Babol,IR.Iran Mahmood Monadi dr.monadi@yahoo.com 100319475328460052311 100319475328460052311 Yes Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol,IR.Iran.Clinical Research Development Unit of Rouhani Hospital, Rouhani Hospital, Babol University of Medical Sciences,Babol,IR.Iran