PMC4501556_01
1.5 cm left upper lobe cavitary nodule.
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The largest was 1.5 x 1.5 cm in the left upper lobe with cavitation (Fig. 1).
Rounded inferio-medial left lower lobe nodule present on CT on original CT scan (left); absent just prior to initiation of treatment (right).
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CT of sinus/neck were normal and in fact, on repeat chest CT several weeks later lung nodules contralateral to biopsy and prior to any therapy were smaller in size (Fig. 2).
a (left): H&E stain of left upper lobe nodule at high power demonstrating absent normal lung architecture and diffuse inflammatory cell infiltrate with both PMNs and plasma cells (indicating some degree of chronicity) present. 3b (right): Lower power view with blood vessels and bronchi present; though there is fibrotic reaction surrounding the blood vessel, there is no evidence of vasculitis.
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Pathology did not show granuloma, malignancy or AFB; rather, was an abscess (Fig. 3).