She retrospectively reported cooking over open fires.
A follow-up CT scan at 6-months showed completely stable appearances, with some pulmonary nodules, likely intrapulmonary lymph nodes, and part calcified mediastinal lymphadenopathy. Clinically she remained well having gained 2 kg in weight, with no night sweats, fevers, cough or breathlessness. She is due further follow-up at 18 months. A 74-year-old woman with a 20-year history of non-productive cough underwent a CT scan as part of evaluation of a left lower lobe calcified nodule. She was otherwise healthy and examination was unremarkable. The CT scan identified curvilinear shadowing in the right middle lobe and a second non-calcified nodule Luminespib inferiorly Selleck CDK inhibitor in the left lower lobe. Right middle lobe bronchial washings were culture negative for bacterial or fungal infection and there were no malignant cells.
Auramine stain and TB cultures were negative. An FDG-PET scan demonstrated normal metabolic activity in the nodules but identified increased activity in enlarged right paratracheal, para-oesophageal and bilateral hilar lymph nodes (SUV 5-7) and an incidental right adrenal adenoma. EBUS-TBNA of the right paratracheal lymph node macroscopically showed lightly bloodstained material that contained small black flecks up to two millimetres in diameter. Microscopically there were striking amounts of anthracotic macrophages, arranged in aggregates and as singly dispersed cells. No multinucleated giant cells, necrosis or malignant cells were seen and was auramine and culture negative for TB. A follow-up CT scan at 12 months showed no significant change in the appearance of the lung with no new nodules or significant change in the existing nodules. She was asymptomatic and due further follow-up at 18 months. A 68-year old Pakistani
woman presented with persistent cough and wheeze. Past Ergoloid medical history included atrial fibrillation, hypertension, hypothyroidism, asthma and IgA nephropathy. Examination was unremarkable. CT chest demonstrated mediastinal and hilar lymphadenopathy, and a small, non-specific left-sided pulmonary nodule. An EBUS-TBNA was performed on the mediastinal and hilar lymph nodes. No black pigment was seen macroscopically. Microscopically large numbers of anthracotic macrophages were seen, singly distributed and in dense clusters. There was no multinucleated giant cell reaction, necrosis or malignant cells and was culture, smear and PCR negative for TB. A follow-up CT scan at 9 months revealed unchanged appearances of the pulmonary nodule and mediastinal lymphadenopathy. She remained clinically well and is due a further follow-up CT imaging at 24 months. A 65-year old Punjabi woman with a 3-year history of cough was referred for investigation. She denied any associated symptoms. Ten months prior to presentation she had been treated for presumed TB, on the basis of enlarged mediastinal lymph nodes on CT imaging and a strongly positive mantoux test.