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a. Chest x-ray. b. HRCT thorax.
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It also showed mosaic attenuation of both lungs, suggestive of small airway disease (Fig. 1b).
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a. Chest x-ray. b. HRCT thorax.
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It also showed mosaic attenuation of both lungs, suggestive of small airway disease (Fig. 1b).
Bronchoscopic images (black arrow: right main bronchus; white arrow: superior segment of the right lower lobe (RLL); checked arrow: basal segment of RLL; striped arrow: right middle lobe (RML)). a. Carina, at diagnosis. b. Bronchus intermedius and the opening of RLL, at diagnosis; The RML opening was obliterated by the endobronchial nodule and not visible.. c. Lower trachea and carina, after the 7 months of antibiotic treatment. d. Bronchus intermedius and the opening of RML and RLL, after the 7 months of antibiotic treatment.
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The RML opening was completely obliterated by the nodules (Fig. 2a-b). On follow-up bronchoscopy, the endobronchial nodules became remarkably fewer and smaller (Fig. 2c-d).
Microscopy of the biopsy of an endobronchial nodule. a. Hematoxylin-eosin staining, x10, showing dense lymphoid infiltrates. b. Immunohistochemical CD3 staining, x10. c. Immunohistochemical CD20 staining, x10.
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The biopsy of the endobronchial lesions showed dense lymphoid infiltrates and some polymorphs in the underlying stroma (Fig. 3a). The lymphoid cells included mixed populations of CD3+ and CD20+ cells (Fig. 3b-c).