PATHOLOGY REPORT
MICROSCOPIC DESCRIPTION: 1,2. Sections of the lung wedges show preserved architecture. There is non-necrotising granulomatous inflammation with many granulomas. They follow lymphatic distribution around the broncho vascular bundles, in the interlobular septa and subpleural. They comprise nodular aggregates of epithelioid histiocytes with multinucleated giant cells. The granulomas are well-defined and they are surrounded by some fibrosis and occasional lymphocytes. The intra-alveolar spaces are unremarkable. There is no evidence of organising pneumonia. No neutrophils are seen. The blood vessels show no evidence of vasculitis. No evidence of malignancy is identified. The features are not typical for psittacosis. The Gram stain shows no bacteria. The Grocott stain shows no fungi. The Ziehl-Neelsen stain shows no acid-fast bacilli.
DIAGNOSIS: R upper and mid lobe wedges: Non-necrotising granulomatous inflammation, which could be consistent with sarcoidosis in the appropriate clinical setting.