Lungs biopsy

Lung Bronchiolitis obliterans diagnosed with lung biopsy Bronchiolitis obliterans diagnosed with pulmonary function tests and radiology0 Bronchiolitis obliterans organizing pneumonia... 

Pathologic confirmation of lung cancer is established by examination of sputum cytology and/or tumor biopsy by bronchoscopy, mediastinoscopy, percutaneous needle biopsy, or open-lung biopsy. 

E. TPE is caused by microfilariae in the lungs and hyperimmune responsiveness to bancroftian or malayan filariasis. Paroxysmal respiratory symptoms may fluctuate in severity. Eosinophilia, almost always present, is usually very high, and the absence of microfilariae in the blood does not rule out TPE. A presumptive clinical diagnosis can be made by response to therapy without a lung biopsy. Diethylcarbamazine for 14 days is an effective therapy that can be repeated if symptoms persist. The role of ivermectin in TPE has not been established. 

A 32-year-old woman rapidly developed progressive deterioration of respiratory function leading to end-stage lung disease (103). An open lung biopsy showed an inflammatory process with extensive accumulation of free silica. 

Dodson RF, Hurst GA, Williams MG, et al. 1988. Comparison of light and electron microscopy for defining occupational asbestos exposure in transbronchial lung biopsies. Chest 94 366-370. 

Common pathogenic bacteria may be responsible (Staphylococcus aureus, Streptococcus pneumoniae) but often organisms of lower natural virulence (Enterobacteriaceae, viruses, fungi) are causal and strenuous efforts should be made to identify the microbe including, if feasible, bronchial washings or lung biopsy. 

Chronic salicylate toxicity can cause pulmonary injury, leading to respiratory distress. Lung biopsy may show diffuse alveolar damage and fibrosis (20). 

Grabe DW, Manley HJ, Kim JS, McGoldrick MD, Bailie GR. Respiratory distress caused by salicylism confirmed by lung biopsy. Clin Drug Invest 1999 17 79-81. 

A 35-year-old woman with ulcerative colitis who had taken mesalazine 1.5 g/day for about 40 days developed a low-grade fever with bilateral eosinophUic pulmonary infUtrates (confirmed by transbronchial lung biopsy)... 

A 33-year-old man with a 3-year history of Crohn s disease had previously received a weU-tolerated single infusion of infliximab. When, 14 months later, he received a second infusion for exacerbation of the disease he had no immediate adverse effects, but complained of myalgia, arthralgia, nausea, and vomiting 7 days later and received diphenhydramine. After 3 days he had dyspnea, fever, and chills. An open lung biopsy showed features of eosinophilic pneumonia and no... 

A 44-year-old woman received interferon alfa 6 MU/ day for relapse of chronic myeloid leukemia 7 years after successful bone marrow transplantation. About 2 years later, interferon alfa was withdrawn because of diffuse erythematous skin lesions with discoid lupus erythematosus on skin biopsy and severe dysphagia with esophagitis and pseudomembranes at endoscopy. Fever, bilateral pulmonary infiltrates, and respiratory distress syndrome subsequently developed, and she required mechanical ventilation. An open lung biopsy showed features of chronic pulmonary graft-versus-host disease. All her symptoms completely resolved with ciclosporin and corticosteroids. An infectious cause was ruled out. 

A 53-year-old Japanese man, who had taken skullcap intermittently for hemorrhoids, developed recurrent interstitial pneumonitis (17). Re-challenge, after he had stopped taking the herbal remedy and had become symptom free, resulted in a high fever and signs and symptoms of interstitial pneumonitis. Transbronchial lung biopsy showed Ijmphocytic alveolitis with eosinophilic infiltration. The symptoms subsided again after withdrawal. 

A 21-year-old man developed AIDS followed by Pneumocystis proved pneumonia. About a year after a booster immunization with MMR vaccine, he developed measles giant-cell pneumonia, confirmed by trans-bronchial and thoracoscopic lung biopsies. The entire genome of the isolated strain and that of the currently used vaccine strain Moraten were subsequently sequenced and were almost identical. 

Interstitial pneumonitis with severe respiratory failure has been reported in two patients (SEDA-21, 389) (SEDA-22, 418). One patient improved after mycophenolate mofetil was withdrawn, but interstitial fibrosis was found on serial lung biopsies. The other patient died from respiratory failure 3 months later. Although other drugs may have been involved in these two patients, one other reported case with recurrence of respiratory failure on each rechallenge of mycophenolate is particularly convincing. 

A heroin addicted patient, who had been foUowed up for 6 months for increasing dyspnea due to chronic cor pulmonale, was admitted to an intensive care unit. She died shortly after. Postmortem lung biopsies showed talc particles within alveolar walls and alveolar macrophages, as well as alterations in blood vessels (26). 

Hypersensitivity pneumonitis has been attributed to occupational exposure to tetrachloroethylene in a 42-year-old dry cleaner the diagnosis was confirmed by lung biopsy (1). 

A 33-year-old man taking co-trimoxazole developed bilateral pulmonary infiltrates and a fever of 39 C after 2 weeks (25). Co-trimoxazole was withdrawn. The fever resolved 6 days later. A lung biopsy showed non-specific interstitial pneumonia. A lymphocyte stimulation test for co-trimoxazole was positive. 

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