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What does my lung biopsy diagnosis mean?

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Posted on Wed, 5 Nov 2014
Question: Hello Dr, I had a lung biopsy last week and the results have come in. Have appointment next week with my Dr (Pulmonary Specialist), yet I really would like some answers as to what this report means. I am not a doctor but I like seeing benign, etc. Can you help? Report reads:

Diagnosis:

Fungal spherules consistent with Coccidioides organisms among
necrosis and chronic inflammation, see comment

Comment:
Core biopsies show rare fungal spherules consistent wtih Coccidioides organisms that are highlighted
by GMS and PAS, with foci of necrosis chronic lymphohistiocytic inflammation and fibrosis. Clinical
correlation is required.

Microscopic Description:
Aspirate smears show scant cellularity with occasional respiratory bronchial-type epithelial cells in a
background of blood. Occasional histiocytes are present. Core biopsies show portions of necrosis,
fibrosis, chronic lymphohistiocytic inflammation and scant benign lung parenchyma. A2 core: GMS and
PAS highlights occasional fungal organisms. A3 core: GMS and PAS highlight rare fungal organisms.
AFB is negative on both cores, A2 and A3. NLS/ckm

Appropriately reacting controls have been performed for all stains on this case as required. All
stains/special studies on this case have been ordered by the rendering pathologist and are medically
necessary for evaluation and/or diagnosis of the specimen.
Additional Stains Performed
A2:GMS,


doctor
Answered by Dr. Vivek Chail (54 minutes later)
Brief Answer:
You have fungal infection in right lung

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
After having gone through your reports I find that there was a nodule in right lung apex and you had a CT guided lung biopsy done few days back.

I have done many such biopsies and am familiar with the procedure you have undergone in which a sample of lung tissue is sent to the lab for histopathological analysis.

In your report the comment found is
Core biopsies show rare fungal spherules consistent wtih Coccidioides organisms that are highlighted by GMS and PAS, with foci of necrosis chronic lymphohistiocytic inflammation and fibrosis.

This means that you have a fungal lung infection which is causing the nodule in right lung apex.

Fungal infections are slow growing and usually got by inhaling the spores and your condition is slightly uncommon in occurrence.

Since it is not a tumor, the word benign has not been used.

There is no need to worry as it is treatable by medications which will have to be given by the pulmonologist.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (9 minutes later)
Dr. XXXXXXX for your prompt response. I ease my mind; I felt the word benign was a good one! Perhaps the infection is what we call "valley fever" in AZ. It was initially discovered over two months ago at an ER visit due to a car accident I was in. When I went for the biopsy, it had reduced in size. Thank you again Dr.
Kind regards, XXXX
doctor
Answered by Dr. Vivek Chail (56 minutes later)
Brief Answer:
Wish you a quick recovery

Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.

The term valley fever is also used and you might have got the infection since a past few months.

The fact that it has reduced in size signifies a good prognosis.

The word benign is usually reserved for tumors and hence not widely used for infections.

Wish you a quick recovery

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

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Practicing since :2002

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What does my lung biopsy diagnosis mean?

Brief Answer: You have fungal infection in right lung Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. After having gone through your reports I find that there was a nodule in right lung apex and you had a CT guided lung biopsy done few days back. I have done many such biopsies and am familiar with the procedure you have undergone in which a sample of lung tissue is sent to the lab for histopathological analysis. In your report the comment found is Core biopsies show rare fungal spherules consistent wtih Coccidioides organisms that are highlighted by GMS and PAS, with foci of necrosis chronic lymphohistiocytic inflammation and fibrosis. This means that you have a fungal lung infection which is causing the nodule in right lung apex. Fungal infections are slow growing and usually got by inhaling the spores and your condition is slightly uncommon in occurrence. Since it is not a tumor, the word benign has not been used. There is no need to worry as it is treatable by medications which will have to be given by the pulmonologist. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek