Presentation
Pulmonary nodule.
Patient Data
There is a 20mm nodular lesion within the LUL which is PET avid.
Case Discussion
Biopsy
MICROSCOPIC DESCRIPTION:
Sections show fragments of lung parenchyma and bronchial mucosa. Mostly in the parenchyma there is a moderate infiltrate of mononuclear chronic inflammatory cells, mostly macrophages, with lesser numbers of eosinophils and rare neutrophils. The inflammatory infiltrate is both within the alveolar spaces and the alveolar septa. Granulomata are not identified. There is no evidence of malignancy. PAS and ZN stains are negative for fungi and acid fast bacilli respectively.
DIAGNOSIS: Left upper lobe biopsy: Non-specific active chronic inflammation.
Bronchial washings
Gram positive bacilli : Nocardia species