PMC10415754_01
Chest X-ray showing patchy increased density in the left lower lobe, lingula, and right middle and lower lobes.
gr1.jpg
PMC10415754_01_gr1.jpg
fig1
Chest X-ray indicated a patchy increased density in the left lower lobe, lingula, and right middle and lower lobes (Fig. 1).
CT angiography of the chest showing multiple, fluffy, nodules of varying size and ill-defined margins throughout both lungs.
gr2.jpg
PMC10415754_01_gr2.jpg
fig2
However, multiple, fluffy, nodules of varying size and ill-defined margins were seen throughout both lungs (Fig. 2).
High resolution CT of the chest remonstrating the nodules with feeding vessel sign.
gr3.jpg
PMC10415754_01_gr3.jpg
fig3
Pulmonology was consulted and, based on the findings on high resolution CT scan of the chest (Fig. 3), the decision was made to perform navigational bronchoscopy to obtain endobronchial and transbronchial lung biopsies.
Crystalline refractile foreign body fragments (arrow and arrowhead) with surrounding dense neutrophilic infiltration.
gr4.jpg
PMC10415754_01_gr4.jpg
fig4
Moreover, approximately 55 cc of thick pale orange fluid was obtained via bronchial wash of right lower lobe which showed scattered refractile material surrounded by dense neutrophilic and mononuclear infiltration (Fig. 4, Fig. 5).