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1 Division of Pulmonary Medicine
2 Associate in Medicine
3 Resident in Pathology
4 Professor of Medicine
Whether permanent structural lung changes follow pulmonary alveolar proteinosis (PAP) is not known. A patient with PAP, but with no evidence of lung fibrosis, became asymptomatic spontaneously. However, 13 years after the onset of his illness he died from pulmonary insufficiency due to lung fibrosis. This suggests that the typical histologic picture of PAP is only a stage of a disease in which the end stage is fibrosis.
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