Week 498: Case 3

1. Presented by Peter Illei, M.D. and prepared by Safia Salaria, M.B.B.S.

49-year-old female from the Bahamas with no significant past medical history,who presented for evaluation of chronic cough and abnormal CT scan and open lung biopsy. The patient states that she was doing quite well and was free of any respiratory symptoms until 2 years ago. At that time she developed a cough that lasted for several months. She received empiric therapy for many different ailments including sinus symptoms, reflux, and inhaler therapy. She is unable to recall the precise medications used, but states that these did not have any improvement in her symptoms. Subsequently she underwent a CT scan, which demonstrated few small subpleural nodules, nodular densities in each lung, and minimal fibrosis in the bilateral apices. This was followed expectantly and demonstrated no changes on serial CT scans. Because of persistent symptoms, she underwent an open lung biopsy.