AFB cultures were negative x3.
Immediately prior to the surgical resection of the calvarial mass, the Pulmonary Service performed a bronchoscopy with bronchoalveolar lavage. Bronchoalveolar lavage was negative for fungal organisms, pneumocystis carini, viral effect, and malignancy. Biopsy of endobronchial lesions was also performed during the bronchoscopy which revealed the following:
MACROSCOPIC DESCRIPTION:
"Lung Tissue": Six scant fragments of white-tan tissue and red-brown blood. The largest fragment measures 0.2 cm.
MICROSCOPIC DESCRIPTION: Sections of the biopsy revealed inflamed fibrous tissue with prominent submucosal collections of macrophages. Additional staining of the lung biopsy was performed (calcium/von Kossa), revealing the presence of calcospherites, (Michaelis-Gutmann bodies). Special stains for infectious organisms (GMS, AFB, mucicarmine, Gram stain, Fites, and Steiner) were negative. Neoplastic change was not present.
DIAGNOSIS: Reactive Squamous Metaplasia with Submucosal Proliferation of Macrophages and Acute and Chronic Inflammation, consistent with Malakoplakia.