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case_images: Cytology of BALF and biopsy tissue at bronchoscopy at diagnosis. (a) Papanicolaou staining revealed pale green-stained granular non-structural material and foamy macrophages. (b) Acidophilic fine granular material was found in the peripheral airspace. (c) Fine granular material was positive for SP-A by immunostaining. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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case_images: SP-A by immunostaining (Fig. 1). Serum anti-GM-CSF antibodies were abnormal (93.7 U/ml, reference value < 1.7 U/ml), leading to a diagnosis of autoimmune PAP.
case_images: Chest CT findings in the upper and lower lung fields before and after atorvastatin administration. (a) Prior to the initiation of oral statin therapy, a diffuse crazy-paving pattern was evident in both lung fields. (b) After 8 months of oral statin treatment, improvements were observed in the ground glass and reticular changes in the bilateral lower lobes. (c) After 12 months of oral statin treatment, significant enhancements were noted in the ground glass and reticular changes throughout the entire bilateral lung field.
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case_images: Subsequent computed tomography revealed a significant improvement in the Crazy-paving pattern observed in the bilateral lung fields, which had nearly disappeared during the examination conducted in March 2023, one year after the commencement of statin treatment (Fig. 2).