Interpret results of needle biopsy
Patient: I was hospitalized with chest pain and pneumonia with a quarter size lesion on my right lung. First a bronchoscopy was performed and I was told my lung was too inflamed to take a biopsy. 2 days later a needle biopsy was performed, but I still do not understand the results. I am still having chest pain and don t follow up with my pulmonary doc for weeks. I m hoping someone can help me better understand the findings which I have copied and are as follows: Sections show an acute lung injury pattern with reactive type 2 cells. They are associated with acute and chronic inflammatory cells infiltrating including some eosinophils, and as well as neutrophils, some of which are in alveolar walls and raise the possibility of so-called capillaritis. In addition, there is some airspace fibrin and very focal organizing pneumonia(it is thought to be the dominant pattern). It is hard to know what these findings might mean. I think infection is certainly a differential. I did note that the BAL also grew candida, and although this really does look very much like Candida pneumonia, I would still do at least a GMS stain on the tissue. The differential also includes aspiration, although I do not see definitive foreign material. The presence of an acute lung injury pattern with areas suspicious for capillaritis, also raises the possibility of this to be a manifestation of granulomatosis with polyangiitis (wegener s granulomatosis), or at least likely another vasculitic process. A GMS stain is performed and demonstrates no fungul or yeast like organisms. I am undergoing further blood tests and follow up with my pulmonary doc in a few weeks. I really am desperate to better understand these results. Doctor: Can u Share your CT scan plates and reports to know exactly how much of the lung is involved and how many lesions.