New study highlights role of pCLE in detecting mild PAP through optical biopsy

Probe-based confocal laser endomicroscopy (pCLE) is a valuable diagnostic tool for detecting mild pulmonary alveolar proteinosis (PAP), offering specific and consistent imaging findings across both mild and severe cases, according to a study.

This method may improve the accuracy of diagnosing mild PAP, which is often difficult to detect with traditional biopsy techniques due to the patchy distribution of lesions.

The study included 5 patients, 3 with mild PAP and 2 with severe PAP. Using pCLE during bronchoscopy, the team observed specific diagnostic features, such as giant cells with strong fluorescence and thin alveolar walls. The images from mild PAP cases were consistent with those from severe cases, suggesting similar dysfunction in alveolar macrophages across both disease severities.

All patients with mild PAP either remained stable or improved over a follow-up period of ≥3 years.

The study concludes that this technology holds promise for improving diagnostic accuracy in early-stage PAP cases.

Reference
Okamura T, Morikawa S, Horiguchi T, et al Optical Biopsies Using Probe-Based Confocal Laser Endomicroscopy for Autoimmune Pulmonary Alveolar Proteinosis. Respiration. 2024;103(4):171-176. doi: 10.1159/000535992. Epub 2024 Feb 22. PMID: 38387451; PMCID: PMC10997271.