A 60-year-old female presented with an intermittent cough and shortness of breath. A chest CT scan showed subpleural reticulation with mild bronchiectasis and peribronchial thickening. In addition, there were small, ill-defined ground-glass opacities in the upper and lower lobe, more prominent in the left lung. Pulmonary function testing documented a moderate restrictive lung defect. The patient’s past medical history is remarkable only for a history of smoking. A wedge biopsy from the left upper and lower lobe was performed.
What is your diagnosis?
a. Non-specific interstitial pneumonia
b. Chronic hypersensitivity pneumonitis
c. Usual interstitial pneumonia
d. Cryptogenic organizing pneumonia
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Submitted by Ivana Savic, University of Belgrade Faculty of Medicine, Belgrade, Serbia, and Carol Farver, MD, University of Michigan, Ann Arbor, Michigan, USA.
Answer to May's Case of the Month
D. Syringocystadenoma papilliferum
Syringocystadenoma papilliferum, also known as papillary syringadenoma, is a warty tumor of the scalp, neck, and/or face that can occur at any age. Histologic sections show cystic epidermal invagination into which papillary structures project. A high-power view shows that the papillae are lined by two rows of cells; the luminal row is composed of columnar cells with decapitation secretions. Plasma cells are present within the stroma.
Submitted by San Yu Maung, Pathologist, Mandalay General Hospital, Mandalay, Myanmar.
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