Correct!
4. 1 and 3
Pulmonary function testing and bronchoscopy are both indicated. VATS is also reasonable although most pulmonary physicians would probably do bronchoscopy first since it is less invasive and has a reasonable chance of yielding a diagnosis (1).
The pulmonary function tests are abnormal (Figure 4).
Figure 4. Pulmonary function testing.
Bronchoscopy with bronchoalveolar lavage revealed no endobronchial masses, an increase in lymphocytes and stains and cultures were negative. Transbronchial lung biopsies were performed (Figure 5).
Figure 5. Panel A: Low power H & E stained transbronchial lung biopsy. Panel B. Higher power view. The biopsy was interpreted as showing organizing pneumonia.
Which of the following is the best diagnosis? (Click on the correct answer to proceed to the next panel)