Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Inflammation Of Epithelium
Question: i am 28 yrs old female.my bronchial biopsy diagnosis shows non specific moderate inflammation of epithelium.Rest of the pathology reports are negative for fungal , afb and malignancy......what does it mean??? do I have asthama or copy or anything XXXXXXX .
CT scan and x-rays shows consolidation I right lower lobe of lungs......currently m suffering from cough with sputum and breathing difficulty since one month,,,,,what possibly I can have???
CT scan and x-rays shows consolidation I right lower lobe of lungs......currently m suffering from cough with sputum and breathing difficulty since one month,,,,,what possibly I can have???
Brief Answer:
Might require procedure like bronchoalveolar lavage to confirm diagnosis
Detailed Answer:
Hi,
Thank you for writing into health care magic.
This is Dr.Riyanka, glad to answer your query.
Inflammation seen in the bronchial biopsy shows non specific inflammatory changes. These do not match with conditions like fungal infections, TB (AFB is acid fast bacilli also known as tuberculosis causing bacteria) and cancer. Therefore your condition is an inflammation of a more chronic nature.
It is not a serious infection but needs treatment after isolating the condition. It is not asthma by definition. There is a type of pneumonia involving the lower lobe of right lung as seen on CT scan and X ray chest. This pneumonia causing agent has still not been isolated. This can happen when there is more than one type of infections, caused by agents other than those causing TB or fungal infections.
There might be a type of non resolving pneumonia if you have been treated with a recommended course broad spectrum antibiotics.
It is essential in discussing your case with a pulmonary medicine specialist and then performing a procedure called bronchoalveolar lavage as is done in cases of non resolving pneumonia. Bronchoalveolar lavage is one method for assessing a number of components of inflammation in the lungs and may be useful in this regard, particularly if combined with new methods for examining inflammatory responses, such as those utilising the polymerase chain reaction to assess cellular expression for inflammatory cytokines and growth factors.
In this technique, a fiberoptic bronchoscope (small tube with a camera) is inserted into the affected part of lung and the cells are collected by washing the pneumonia area. This is done by in an almost painless method.
The cells are then analysed for a number of organisms and tests. This might give more information than a biopsy because it will catch the floating cells from the entire involved area while the biopsy was taken only from a particular area.
The common tests done with the fluid obtained from bronchoalveolar lavage gives an insight into the condition happening in the lungs. The following tests are usually done
1. Gross analysis
2. Cell counts and differential counts
3. Microbiology tests like cultures, Stains and Immunohistochemistry, and Polymerase chain reaction (PCR) and Quantitative or semiquantitative cultures
4. Cell studies
A non resolving one month cough can be due to conditions like uncommon bacteria, Wegeners granulomatosis or atypical mycobacteria.
Once identified, treatment is targeted towards the causative organisms.
If there are any more clarifications kindly write back to me.
If you are satisfied with my reply kindly close the window and leave a feed back.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Might require procedure like bronchoalveolar lavage to confirm diagnosis
Detailed Answer:
Hi,
Thank you for writing into health care magic.
This is Dr.Riyanka, glad to answer your query.
Inflammation seen in the bronchial biopsy shows non specific inflammatory changes. These do not match with conditions like fungal infections, TB (AFB is acid fast bacilli also known as tuberculosis causing bacteria) and cancer. Therefore your condition is an inflammation of a more chronic nature.
It is not a serious infection but needs treatment after isolating the condition. It is not asthma by definition. There is a type of pneumonia involving the lower lobe of right lung as seen on CT scan and X ray chest. This pneumonia causing agent has still not been isolated. This can happen when there is more than one type of infections, caused by agents other than those causing TB or fungal infections.
There might be a type of non resolving pneumonia if you have been treated with a recommended course broad spectrum antibiotics.
It is essential in discussing your case with a pulmonary medicine specialist and then performing a procedure called bronchoalveolar lavage as is done in cases of non resolving pneumonia. Bronchoalveolar lavage is one method for assessing a number of components of inflammation in the lungs and may be useful in this regard, particularly if combined with new methods for examining inflammatory responses, such as those utilising the polymerase chain reaction to assess cellular expression for inflammatory cytokines and growth factors.
In this technique, a fiberoptic bronchoscope (small tube with a camera) is inserted into the affected part of lung and the cells are collected by washing the pneumonia area. This is done by in an almost painless method.
The cells are then analysed for a number of organisms and tests. This might give more information than a biopsy because it will catch the floating cells from the entire involved area while the biopsy was taken only from a particular area.
The common tests done with the fluid obtained from bronchoalveolar lavage gives an insight into the condition happening in the lungs. The following tests are usually done
1. Gross analysis
2. Cell counts and differential counts
3. Microbiology tests like cultures, Stains and Immunohistochemistry, and Polymerase chain reaction (PCR) and Quantitative or semiquantitative cultures
4. Cell studies
A non resolving one month cough can be due to conditions like uncommon bacteria, Wegeners granulomatosis or atypical mycobacteria.
Once identified, treatment is targeted towards the causative organisms.
If there are any more clarifications kindly write back to me.
If you are satisfied with my reply kindly close the window and leave a feed back.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Above answer was peer-reviewed by :
Dr. Raju A.T
thank u so much for the kind reply......I had XXXXXXX test done a long with the FOB ......my histopathology reports shows:
section shows intact bronchial epithelium. Sub epithelium shows moderate infiltration of mononuclear cells......
Diagnosis
Bronchial biopsy - Non specific inflammation.
what this report shows????
my doctor prescribed me Defcort 36 mg along with neksium 40 mg after looking this reports.......
my CT findings showed bilateral diffuse thickening of the period inch I vascular interstitium surrounding vessel and bronchi, interlobular septal thickening with fine to course reticulonodular pattern of the pulmonary parenvhyma ( right lung >left lung).....
evidence of sub- pleural interstitial thickening and thick linear fibrotic bands are seen more so in right upper lobe and middle lobe with associated minimal pleural effusion . the over all parenchymal architecture appears to be preserved.....
after XXXXXXX test my results shows negative for fungal, malignant and afb........
kindly give me an idea about what possibly my problmen is......is it something very serious like COPD or IPF????
or it may be asthama?? or anyother infection ????
section shows intact bronchial epithelium. Sub epithelium shows moderate infiltration of mononuclear cells......
Diagnosis
Bronchial biopsy - Non specific inflammation.
what this report shows????
my doctor prescribed me Defcort 36 mg along with neksium 40 mg after looking this reports.......
my CT findings showed bilateral diffuse thickening of the period inch I vascular interstitium surrounding vessel and bronchi, interlobular septal thickening with fine to course reticulonodular pattern of the pulmonary parenvhyma ( right lung >left lung).....
evidence of sub- pleural interstitial thickening and thick linear fibrotic bands are seen more so in right upper lobe and middle lobe with associated minimal pleural effusion . the over all parenchymal architecture appears to be preserved.....
after XXXXXXX test my results shows negative for fungal, malignant and afb........
kindly give me an idea about what possibly my problmen is......is it something very serious like COPD or IPF????
or it may be asthama?? or anyother infection ????
Brief Answer:
Might be hypersensitivity pnuemonitis
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
The bronchial biopsy and histopathology shows mononuclear cells which signifies inflammation due to certain antigens (hypersensitivity pnuemonitis ). This can be due to an infective eitiology (cause) or an immune related mechanism due to presence of an antigen as there is no organism isolated from the bronchial biopsy therefore other causes of inflammation should be thought of.
Your doctor has prescribed DEFCORT (steroidal anti inflammatory drug ) and NEKSIUM which is to prevent excessive acid secretion by the stomach. There might be a possibility of acid reflux disease in you and that can cause pneumonia like features with inflammation , if the acid reaches the lungs (Accidental aspiration of stomach acid).
The CT findings show inflammatory changes as seen by thickening of vascular interstitium and interlobular septae. This is seen more in the right lung.There is also little amount of fluid collection in the space around the lungs as a result of this inflammation.
However, there is clear mention of the lung parenchymal architecture preservation. This essentially rules out IPF or COPD. Diagnosis like hypersensitivity pnuemonitis might have to be considered with focus on treating your present symptoms. Follow up x rays and CT lungs might have to be repeated depending on your symptoms and its severity.
The thick linear fibrotic bands in the right upper lobe and middle lobe in CT need to be correlated with any respiratory infections you have had since childhood.
Certain lung diseases due to autoimmune and inflammatory causes may take months to years to show typical features on imaging and the complete diagnosis may not be possible during early stages.
It would help to know if your pulmonary function tests (non invasive test) are within normal limits for your age. This will show your true lung volumes and capacities and will help us differentiate between a restrictive and obstructive lung disease.
Since we have already ruled out malignancy and TB therefore you may be relaxed concerning serious diseases.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Might be hypersensitivity pnuemonitis
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
The bronchial biopsy and histopathology shows mononuclear cells which signifies inflammation due to certain antigens (hypersensitivity pnuemonitis ). This can be due to an infective eitiology (cause) or an immune related mechanism due to presence of an antigen as there is no organism isolated from the bronchial biopsy therefore other causes of inflammation should be thought of.
Your doctor has prescribed DEFCORT (steroidal anti inflammatory drug ) and NEKSIUM which is to prevent excessive acid secretion by the stomach. There might be a possibility of acid reflux disease in you and that can cause pneumonia like features with inflammation , if the acid reaches the lungs (Accidental aspiration of stomach acid).
The CT findings show inflammatory changes as seen by thickening of vascular interstitium and interlobular septae. This is seen more in the right lung.There is also little amount of fluid collection in the space around the lungs as a result of this inflammation.
However, there is clear mention of the lung parenchymal architecture preservation. This essentially rules out IPF or COPD. Diagnosis like hypersensitivity pnuemonitis might have to be considered with focus on treating your present symptoms. Follow up x rays and CT lungs might have to be repeated depending on your symptoms and its severity.
The thick linear fibrotic bands in the right upper lobe and middle lobe in CT need to be correlated with any respiratory infections you have had since childhood.
Certain lung diseases due to autoimmune and inflammatory causes may take months to years to show typical features on imaging and the complete diagnosis may not be possible during early stages.
It would help to know if your pulmonary function tests (non invasive test) are within normal limits for your age. This will show your true lung volumes and capacities and will help us differentiate between a restrictive and obstructive lung disease.
Since we have already ruled out malignancy and TB therefore you may be relaxed concerning serious diseases.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Above answer was peer-reviewed by :
Dr. Raju A.T
14 years back I had TB of lungs where my right lung was infected.....but I took complete course and cured....
Can I relate this anywhere with my present condition......
what is this hypersensitive pneuonitis???
will I be cured ?????
Can I relate this anywhere with my present condition......
what is this hypersensitive pneuonitis???
will I be cured ?????
Brief Answer:
The CT scan findings of fibrosis and septal thickening is past TB related
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
Your earlier history of TB 14 years back explains everything.
TB is a chronic infection and the lungs get scarred which remains even after getting cured. After treatment was complete, your lungs started healing and when that happens, the lung tissues develop fibrotic bands and thickened interstitium. This is expected in most patients after having TB. ZThese findings stay for lifetime and cannot be reversed. So even if you were cured of TB years ago, the scars will persist for your lifetime and we can see that on CT findings describing certain lung changes, more involving the right lung.
If the lungs get fibrotic areas and develop changes due to scarring after TB, then this can allow other infections or inflammations to occur more easily at any time in the future. Therefore the inflammation or infection (pneumonitis) might take slightly more time to treat in your case. Hypersensitivity pneumonitis is an inflammation as a result of hypersensitivity reaction or some form of allergy.
You will be cured but it is important to tell the doctors about TB 14 years back with details of treatment taken.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
The CT scan findings of fibrosis and septal thickening is past TB related
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
Your earlier history of TB 14 years back explains everything.
TB is a chronic infection and the lungs get scarred which remains even after getting cured. After treatment was complete, your lungs started healing and when that happens, the lung tissues develop fibrotic bands and thickened interstitium. This is expected in most patients after having TB. ZThese findings stay for lifetime and cannot be reversed. So even if you were cured of TB years ago, the scars will persist for your lifetime and we can see that on CT findings describing certain lung changes, more involving the right lung.
If the lungs get fibrotic areas and develop changes due to scarring after TB, then this can allow other infections or inflammations to occur more easily at any time in the future. Therefore the inflammation or infection (pneumonitis) might take slightly more time to treat in your case. Hypersensitivity pneumonitis is an inflammation as a result of hypersensitivity reaction or some form of allergy.
You will be cured but it is important to tell the doctors about TB 14 years back with details of treatment taken.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Above answer was peer-reviewed by :
Dr. Raju A.T
hello mam.....
my doctor adviced me to go for ABG test where co2 content was seen less while all other pareters were found to be within normal range.....
I went for pft as well but due to cough could not perform the test successfully.....
my Dr has now prescribed me combihale ff 250 for 15 days...
he has also told me that he doubts that there is membrane surrounding my right lung due to which my lung is not able to expand after inhaling O2.....he told me he might go for a surgery for that as my pathological reports are showing no infection as such and I have no other problem except shortness of breathing and cough......can you make any idea how right this diagnosis is???
should I go for second opinion also??
why he has given combihale 250 if he thinks sungery is right option for me???
I was your opinion mam .....kindly help me....I m very very upset about my health condition
my doctor adviced me to go for ABG test where co2 content was seen less while all other pareters were found to be within normal range.....
I went for pft as well but due to cough could not perform the test successfully.....
my Dr has now prescribed me combihale ff 250 for 15 days...
he has also told me that he doubts that there is membrane surrounding my right lung due to which my lung is not able to expand after inhaling O2.....he told me he might go for a surgery for that as my pathological reports are showing no infection as such and I have no other problem except shortness of breathing and cough......can you make any idea how right this diagnosis is???
should I go for second opinion also??
why he has given combihale 250 if he thinks sungery is right option for me???
I was your opinion mam .....kindly help me....I m very very upset about my health condition
Brief Answer:
Please discuss probable surgery details and repeat PFTs
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
The medication combihale ff 250 is a combination of steroids and antihistamines and is given to reduce your symptoms. If your ABG shows low CO2 content then there is a need to try the PFT again. This will clear certain doubts related to lung volumes and lung expansion.
The probability of a membrane surrounding the right lung is still not confirmed. I would like to read through your CT scan report to get a better picture. it is important to know where is the pleural effusion and whether a surgery is really needed to relieve your symptoms.
Surgeries are of many types from the minimal invasive ones using key holes to major surgery where the lungs are approached through the sides of chest. If your right lower lobe consolidation has resolved on a repeat chest X ray after taking medications and if you are not in much discomfort then a decision to perform surgery can be taken after discussing the matter in detail. Please do ask exact details of the surgery your doctor wants to do and how will he be doing it (minimally invasive or thoracotomy.
A second clinical examination and opinion regarding surgery from a TB specialist will surely benefit you. Please go ahead and take another opinion after discussing the probable surgery details with your first doctor.
Please take the medications to reduce your symptoms and if you feel better with medication taken for a week then surgery can wait till you have done your PFTs and spoken to another doctor.
In my opinion, surgery is the last option when medications have failed to show any improvement and your lung function tests show significantly compromised lung function. You might also have to take a lung perfusion test.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Please discuss probable surgery details and repeat PFTs
Detailed Answer:
Hi,
Thank you for writing into health care magic.thank you for writing back with detailed updates.
The medication combihale ff 250 is a combination of steroids and antihistamines and is given to reduce your symptoms. If your ABG shows low CO2 content then there is a need to try the PFT again. This will clear certain doubts related to lung volumes and lung expansion.
The probability of a membrane surrounding the right lung is still not confirmed. I would like to read through your CT scan report to get a better picture. it is important to know where is the pleural effusion and whether a surgery is really needed to relieve your symptoms.
Surgeries are of many types from the minimal invasive ones using key holes to major surgery where the lungs are approached through the sides of chest. If your right lower lobe consolidation has resolved on a repeat chest X ray after taking medications and if you are not in much discomfort then a decision to perform surgery can be taken after discussing the matter in detail. Please do ask exact details of the surgery your doctor wants to do and how will he be doing it (minimally invasive or thoracotomy.
A second clinical examination and opinion regarding surgery from a TB specialist will surely benefit you. Please go ahead and take another opinion after discussing the probable surgery details with your first doctor.
Please take the medications to reduce your symptoms and if you feel better with medication taken for a week then surgery can wait till you have done your PFTs and spoken to another doctor.
In my opinion, surgery is the last option when medications have failed to show any improvement and your lung function tests show significantly compromised lung function. You might also have to take a lung perfusion test.
If there are any more clarifications kindly write back to me.
You will get well soon. Please don't worry.
Thank you,
Dr.Riyanka
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
