Initially, a core biopsy of the right lung lesion was performed but it was non-diagnostic.
A subsequent surgical biopsy of the left lung lesion showed granulomatosis with polyangiitis (previously known as Wegener granulomatosis).
Unfortunately, the patient had a very rapid downhill course with renal failure and expired at the time that treatment for Wegener was going to be started. Stains for microorganisms and cultures were all negative.