Lung case 1
Case writer: A/Prof Nga Min En
Clinical history:
- 83M, history of multiple myeloma, diagnosed 5 years ago, with several relapses. Currently on chemotherapy for relapsed myeloma.
- Presents with a persistently worsening cough, not improving with antibiotics. No significant weight loss.
- CT scan of the lung shows peripheral consolidation and nodules in both lungs, with mass-like consolidation involving almost the entire right lower lobe. Some calcified pleural plaques are seen. No mediastinal or hilar lymphadenopathy is noted.
- Transbronchial biopsy of the right lower lobe is performed.
- What are the histologic findings?
- What are your differential diagnoses?
- What clinical information would be helpful in your diagnostic workup?
- What ancillary tests would you do?
Click picture to enlarge
