Here is the reading on the wedge biopsy: The right upper lobe lung biopsy has both interstitial pneumonitis with a BOOP-like injury pattern as well as patchy bronchopneumonia. It is unclear if these two findings represent concomitant injury or an acute injury(bronchopneumonia) superimposed upon an underlying sub-acute injury pattern(BOOP).The latter possibility may better fit the clinical and radiographic findings.
I told pathologist I was suspecting HP, but he saw no definitive evidence on the biopsy. The biopsy, although via VATS, was pretty small. He saw BOOP-like pattern, but agrees that this does not rule out HP, since, as you pointed out, BOOP is just the nonspecific lung injury. There were no eosinophils on biopsy. However, I am not sure if the patient had already been started on prednisone when that biopsy was performed.
Not much. A follow up IgE was 2600. She had a moldy basement so I was thinking this may be related. An HP panel was sent. What's the best way to check for mold? skin test or serum for IgG's?
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Here is the reading on the wedge biopsy:
The right upper lobe lung biopsy has both interstitial pneumonitis with a
BOOP-like injury pattern as well as patchy bronchopneumonia. It is unclear if these two findings represent concomitant injury or an acute injury(bronchopneumonia) superimposed upon an underlying sub-acute injury pattern(BOOP).The latter possibility may better fit the clinical and radiographic findings.
I told pathologist I was suspecting HP, but he saw no definitive evidence on the biopsy. The biopsy, although via VATS, was pretty small. He saw BOOP-like pattern, but agrees that this does not rule out HP, since, as you pointed out, BOOP is just the nonspecific lung injury.
There were no eosinophils on biopsy. However, I am not sure if the patient had already been started on prednisone when that biopsy was performed.
Not much. A follow up IgE was 2600. She had a moldy basement so I was thinking this may be related. An HP panel was sent. What's the best way to check for mold? skin test or serum for IgG's?
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