Pulmonary Alveolar Proteinosis

"Crazy Paving" is a radiographic term used to describe ground glass opacities with overlying thickening of the interlobular and intralobular septa.  The ddx for this is broad, though the most common causes are:
     -ARDS
     -Bacterial pneumonia
     -Acute interstitial pneumonia
     -Pulmonary alveolar proteinosis

Now that's paving crazy!

Now that's paving crazy!

Pulmonary Alveolar Proteinosis is often either from autoimmune (can consider treating with GS-CSF) or secondary causes (largely exposures, i.e. silica, cement).  Pulmonary lavage by rinsing the alveoli with saline is a mainstay in therapy.

A bit of cost-conscious care... The national average prices:
  Chest X-Ray: $370
  Chest CT: $1900
  Bronchoscopy: $2510