• Toyomitsu Sawai, Yasuhiro Umeyama, Sumako Yoshioka, Nobuko Matsuo, Naofumi Suyama, and Shigeru Kohno.
• Department of Respiratory Medicine, Nagasaki Harbor Medical Center City Hospital, 6-39 Shinchi-machi, Nagasaki 850-8555, Japan. toyosawai@yahoo.co.jp.
• J Med Case Rep. 2014 Aug 19; 8: 279.

IntroductionPulmonary alveolar proteinosis is a rare pulmonary disease characterized by excessive alveolar accumulation of surfactant due to defective alveolar clearance by macrophages. There are only a few published case reports of pulmonary alveolar proteinosis occurring in association with solid cancers. To the best of our knowledge, there are no previously reported cases of pulmonary alveolar proteinosis associated with breast cancer.Case PresentationA 48-year-old Asian woman, a nonsmoker, presented to our institution with a right breast mass. Biopsy examination of the lesion revealed scirrhous carcinoma. A chest computed tomography scan for metastases showed abnormal shadows in both upper lung fields. As a result of flexible fiberscopic bronchoscopy, this patient was diagnosed as having pulmonary alveolar proteinosis. This case was categorized as autoimmune pulmonary alveolar proteinosis due to the positive anti-granulocyte-macrophage colony-stimulating factor antibody. Pulmonary alveolar proteinosis decreased gradually after mastectomy.ConclusionsThe present case involved the coincident occurrence of autoimmune pulmonary alveolar proteinosis with breast cancer; breast cancer may be a factor during pulmonary alveolar proteinosis development.

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