Table 5c.
Further investigative work up for non-USA cases.
| Histopathology | BAL | Microbiology | First recorded lung function |
|---|---|---|---|
| Alveolar spaces contain macrophages and evidence of haemorrhage. A few alveolar spaces lined by fibrin suggesting early hyaline membrane formation. No granulomas were identified | Moderate numbers of macrophages, neutrophils and eosinophils (20%) consistent with active inflammation | Rhinovirus only | FEV1 3.52 L, z score − 1.91, FVC 3.68 L, z score − 2.73, TLC- 5.91 L, z score − 0.82. TLCO-9.02, z score − 0.92. |
| Mild interstitial septal thickening secondary to acute inflammatory cells in the septi and type 2 pneumocyte hyperplasia. The airspaces are distended by a mixture of fibrin balls, neutrophils, macrophages and myofibroblast proliferation, with incorporation of myofibroblasts into the septi | 83% neutrophils | Negative for infection | FEV1 of 1.28 L (31% predicted), forced vital capacity (FVC) of 2.56 L (52% predicted), FEV1/FVC of 50%, residual volume of 3.55 L (227% predicted), normal total lung capacity (6.02 L, 91% predicted) and low-normal diffusion capacity corrected for alveolar volume (99% predicted) |
| Acute diffuse alveolar damage with fibrosis | 45% of macrophages, 42% of neutrophils, 7% of lymphocytes and 6% of eosinophils | Negative for infection | Not mentioned |
| Mildly fibrosed bronchial wall | Bloody, 40% macrophages, 50% neutrophils | Negative for infection | Not mentioned |
| Not done | lipid laden macrophages (55%), lymphocytes(28%) and neutrophils (17%) | Negative for infection | Not mentioned |
| Extensive accumulation of lipid-filled macrophages and deposition of cholesterol clefts and some inflammation representing lipoid pneumonia | 18% lymphocytes, 2% neutrophils, 68% macrophages and 2% eosinophils | Negative for infection | FEV1 = 1.23 L (50% predicted), FVC = 1.37 L (48% predicted) and FEV1/FVC = 89%, TLCO 1.9 (24%predicted), KCO = 1.15 (59% predicted) and TLC = 1.62 L (40% predicted) |
| Multifocal granulomatous inflammation, pneumonitis, organising pneumonia | 39% macrophages, 3% neutrophils, 7% lymphocytes | Negative for infection | TLC 83% of the desired value, FEV1/FVC 86%), diffusion capacity 56% of the desired value |