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?
Here is the reading on the wedge biopsy:
ReplyDeleteThe 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.
ReplyDeleteThere 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?
ReplyDelete