I have just seen this 47 y/o woman for new onset dyspnea. She has had malaise, non-productive cough and DOE for the past 6 weeks. Occasional "low-grade" temps but no fevers.No TOB Hx. She works at a auto air-bag manufacturer and part-time at a Wal-Mart. No other exposures. Exam is pretty unremarkable. PFTs revealed a mild restrictive deffect with low DLCo.
Any suggestions? (BTW, ignore the small apical PTx, that was from vigorous bronching).
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Couldn't zoom in but it looks like diffuse tiny nodules. Doesn't look like any ground glass but can't tell from film (and if it's high res or not).
Although there is a low grade temp, I would think she would be more symptomatic if this was, say, disseminated histo - but she is around that area geographically.
Malignancy is a possibility. Does she have adenopathy? What types of exposures are at work (the airbag place of work)? The radiograph does not seem consistent with a diagnosis of HP but this could be a consideration.
I assuem you bronched with BAL for micro, cell count cytology and TBBX?
looks like HP to me..........
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