{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:44:54Z","timestamp":1791989094585,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytopathology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by abnormal accumulation of surfactant within the alveoli, leading to impaired gas exchange and progressive respiratory symptoms. We report a 40\u2010year\u2010old stone grinder presenting with chronic cough, dyspnea, weight loss and hypoxemia. High\u2010resolution computed tomography showed bilateral ground\u2010glass opacities, while bronchoalveolar lavage (BAL) yielded characteristic milky fluid. Cytological examination demonstrated PAS\u2010positive eosinophilic material with foamy macrophages, confirming secondary PAP related to silica exposure. Lung biopsy was not feasible because of the patient's condition. Whole lung lavage resulted in marked clinical, radiological and oxygenation improvement, highlighting BAL cytology's diagnostic value.<\/jats:p>","DOI":"10.1111\/cyt.70139","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:51:01Z","timestamp":1791985861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unravelling A Rare Diagnosis: Pulmonary Alveolar Proteinosis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4946-4247","authenticated-orcid":false,"given":"Rohan","family":"Govil","sequence":"first","affiliation":[{"name":"Department of Pathology Mahatma Gandhi University of Medical Sciences and Technology  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-0695","authenticated-orcid":false,"given":"Arpita","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Pathology Mahatma Gandhi University of Medical Sciences and Technology  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8329-9218","authenticated-orcid":false,"given":"Sunil Kumar","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Mahatma Gandhi University of Medical Sciences and Technology  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2056-786X","authenticated-orcid":false,"given":"Anjana","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Mahatma Gandhi University of Medical Sciences and Technology  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3283-0756","authenticated-orcid":false,"given":"Pooja","family":"Rani","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Mahatma Gandhi University of Medical Sciences and Technology  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s13023-018-0846-y","article-title":"Prevalence & Healthcare Burden of Pulmonary Alveolar Proteinosis","volume":"13","author":"McCarthy C.","year":"2018","journal-title":"Orphanet Journal of Rare Diseases"},{"issue":"5","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"e199","DOI":"10.1016\/j.amjmed.2017.12.019","article-title":"Severe Pulmonary Alveolar Proteinosis in a Young Adult","volume":"131","author":"Kamboj A.","year":"2018","journal-title":"American Journal of Medicine"},{"issue":"13","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"7092","DOI":"10.3390\/ijms25137092","article-title":"A Comprehensive Outlook on Pulmonary Alveolar Proteinosis\u2014A Review","volume":"25","author":"Wo\u0142oszczak J.","year":"2024","journal-title":"International Journal of Molecular Sciences"},{"issue":"2","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"200018","DOI":"10.1183\/20734735.0018-2020","article-title":"Pulmonary Alveolar Proteinosis: From Classification to Therapy","volume":"16","author":"Salvaterra E.","year":"2020","journal-title":"Breathe"},{"key":"e_1_2_10_6_1","unstructured":"B.Amini Y.Weerakkody andC.Kearns \u201cGround\u2010Glass Opacification. Radiopaedia.Org \u201d(2025)."},{"issue":"1","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.21037\/tlcr.2017.01.02","article-title":"Pulmonary Ground\u2010Glass Opacity: Computed Tomography Features, Histopathology and Molecular Pathology","volume":"6","author":"Gao J. W.","year":"2017","journal-title":"Translational Lung Cancer Research"},{"issue":"5","key":"e_1_2_10_8_1","first-page":"576","article-title":"Opacit\u00e0 Polmonare Diffusa a Vetro Smerigliato (\u201cGround Glass\u201d). Guida All'interpretazione del Quadro Con Tomografia Computerizzata Ad Alta Risoluzione (TCAR) [Diffuse Ground\u2010Glass Opacity of the Lung. A Guide to Interpreting the High\u2010Resolution Computed Tomographic (HRCT) Picture]","volume":"88","author":"Zompatori M.","year":"1994","journal-title":"Radiologia Medica"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"701","DOI":"10.2147\/TCRM.S193884","article-title":"Update on Diagnosis and Treatment of Adult Pulmonary Alveolar Proteinosis","volume":"17","author":"Iftikhar H.","year":"2021","journal-title":"Therapeutics and Clinical Risk Management"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1186\/s42077-022-00213-6","article-title":"Whole Lung Lavage in Pulmonary Alveolar Proteinosis: Anesthetic Management and Challenges","volume":"14","author":"Manohar M.","year":"2022","journal-title":"Ain\u2010Shams Journal of Anesthesiology"},{"issue":"6","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1378\/chest.09-2295","article-title":"Whole\u2010Lung Lavage for Pulmonary Alveolar Proteinosis","volume":"136","author":"Michaud G.","year":"2009","journal-title":"Chest"}],"container-title":["Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cyt.70139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:51:06Z","timestamp":1791985866000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cyt.70139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":10,"alternative-id":["10.1111\/cyt.70139"],"URL":"https:\/\/doi.org\/10.1111\/cyt.70139","archive":["Portico"],"relation":{},"ISSN":["0956-5507","1365-2303"],"issn-type":[{"value":"0956-5507","type":"print"},{"value":"1365-2303","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cyt.70139"}}