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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does My Lung Biopsy Result Mean?

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,
Fri, 6 Feb 2015
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Pulmonologist 's  Response
Thanks for your question on HCM.
Your biopsy report is suggestive of fungal infection in lung.
Fungal spherules under microscopy is the diagnostic evidence for fungal infection of lung.
Another supportive evidences in your report are
1. Negative for AFB (TB is ruled out)
2. Chronic necrotizing inflammation with histiocytic infiltration.
3. GMS and PAS stain positive.
All these favour fungal infection with coccoidiodomycosis (fungus).
So better to consult pulmonologist and start antifungal drugs.
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What Does My Lung Biopsy Result Mean?

Thanks for your question on HCM. Your biopsy report is suggestive of fungal infection in lung. Fungal spherules under microscopy is the diagnostic evidence for fungal infection of lung. Another supportive evidences in your report are 1. Negative for AFB (TB is ruled out) 2. Chronic necrotizing inflammation with histiocytic infiltration. 3. GMS and PAS stain positive. All these favour fungal infection with coccoidiodomycosis (fungus). So better to consult pulmonologist and start antifungal drugs.