What does the following test result of lung indicate?
Patient: I need help please This is some reports about my wife She can t make more testing like open lung biopsy it s impossible. I d like to know if my wife has lymphoma, and if so, which type We need to take appropriate actions. Please reply to me. My wife can t walk 5 steps at the same room and she live with 7 liters oxygen 24 hour a day if she move about 5 steps the oxygen level will be less than 50 . X- RAY REPORT 9-11-2009 Chest Radiograph ( PA View ) Revealed :- Both lung fields show multiple reticulonodular infiltration Giving honey comb appearance with tendency to cystic changes for correlation with clinical data end previous films. Pathology Report Material: C.T. guided fine needle aspiration cytology (FNAC) of a lung nodule & liver focal lesions. Date of aspiration: 24/11/2009 CLINICAL PICTURE: C.T. guided fine needle aspiration cytology (FNAC) of a lung nodule & liver focal lesion smeared over eight slides. MICROSCOPY: Cellular lung smears formed of many groups of epitheloid cells having large nuclei and abundant esinphilic cytoplasm. Many groups of hyperplastic bronchial cells exhibiting mild-moderate atypia were detected. The background was infiltrated with chronic inflammatory ceels mainly lymphocytes with moderate number of uniuncleated histiocytes. Few multinucleated giant cells were observed. The liver aspirate showed many groups of liver cells having bland cntral nuclei over background having infiltrated with lymphocytes. DIAGNOSIS: LUNG NODULE & LIVER FOCAL LESION: C.T. guided Fine Needle Aspiration Cytology (FNAC) Lymphoroliferative disorder suggestive for granulomatous inflammation for immunophenotyping confirmation. PATHOLOGY REPORT Microscopic: Examination of the films received many red cells, many scattered small, intermediate and large lymphoid cells with very few polmonuclear leucocytes. Diagnosis: Lung nodule and liver focal lesions, FINDING ARE IN FAVOUR OF MALIGNANT LYMPHOMA. -CASE FOR TISSUE BIOPSY FOR IMMUNOPHENOTYPING. PATHOLOGY REPORT GROSS: - Referred 8 FNAC smear slides, labeled by patient s name. four of the slides are labeled for site as liver and the other 4 as lung. All slides are examined and re-enclosed. - Three of the slides are de-stained after routine examination, then immunostained for LCA. CK & NSE. MICROSCOPY: - Liver and lung FNAC smears show blood and scattered groups of small, medium and large round cells. The FNAC smears also rich in neutrophils. - The immunostained smears show negative staining for CK & NSE and positive staining for LCA. Conclusion: Cytology slides ; re-staining for immunophenotyping: FINDINGS ARE CONSISTENT WITH NON-HODGKIN S LYMPHOMA ; MIXED SMALL AND LARGE CELL. PATHOLOGY REPORT One of the referred FNAC smear slides is de-stained after routine Examination, then immunostained for CD 20 as requested MICROSCOPY The immunostained smear shows a majority of CD 20 â??megative cells and few â?? likely reactive- positively stained small lymphocytes. CONCLUSION: Cytology slides ; restining for CD 20 Most cells are CD 20 negative. Scattered positive (likely reactive) small lymphocytes. Complete Blood Count Ref. Range Haemoglobin 5.6 gm/dl 12.1-16.6 Haematocrit 20.0% 30-40 Red cells count 3.37 mil/cmm 4.2-5.4 Red cell indices MCV 59.3 fl 78-94 MCH 16.6 pg 26-32 MCHC 28.0 gm/dl 31-34 RDW 20.9% Total leucocytic count 11,900 /cmm 4,000-11000 Differential Count Basophils 0 % 0-1 Eosinophils 1 % 1-4 Staff 2 % 1-7 Segmented 68 % 40-75 Lymphocytes 23 % 20-45 Monocytes 6 % 1-8 Others Platelet Count 800,000 /cmm 150,000-450,000 All the best, Doctor: Hello,  As you explain the history she has non-Hodgkin lymphoma which needs chemotherapy. I am sorry about your wife's situation.   Hope I have answered your query. Let me know if I can assist you further.  Take care  Regards, Dr Jnikolla, Pulmonologist