Correct!
3. VATS lung biopsy
Reinstituting her therapy seems unlikely to be helpful when 6 months of therapy was not. It also seems there is little to be gained from a repeat bronchoscopy. Therefore, a VATS lung biopsy was performed (Figure 3).
Figure 3. Representative photomicrographs of the patient’s VATS lung biopsy. A: At low magnification (H & E, 20X), scattered nodular granulomas (1-2 mm) are present in the peribronchial spaces. B: At higher magnification (H & E, 200X) a relatively well-formed nut non-necrotizing granuloma (right side) is present in the airspace adjacent to a small bronchiole (left of center).
What is the most likely diagnosis? (Click on the correct answer to be directed to the sixth of seven pages.)