Exudative cellular bronchiolitis...?
Question: what percentage of patients with the following scenario should get a bronchoscopy biopsy to view the pathology to best determine diagnosis? This is for someone who accidentally aspirated food or liquid in mid December and since have had constant itchiness in lungs and shortness of breath (worst side effects have been difficulty finishing a sentence without running out of breath feeling like suffocating from inside). The itch at times has been very intense with no way known yet on how to alleviate it. They have also found walking a few blocks in temperatures lower than 55 degrees to exacerbate things on a few occasions.
The first Pulmonologist they saw did not find bronchiectasis but I don’t believe they even considered the exudative form of cellular bronchiolitis. Next will be a second opinion at a different facility next week.
Scenario: patient had an aspiration event with subsequent findings:
Clinical findings: itchiness in lungs, shortness of breath (no wheezing or coughing).
Tree in bud and signet ring opacities.
Left lung has 3 calcified granulomas measuring up to 5mm.
Right lung has 6 non calcified nodules measuring up to 3mm. Also, left infrahilar calcified granuloma measuring 7mm.
Also, what kind of treatment options have been seen as effective for exudative cellular bronchiolitis (if applicable)?
Links to a few videos used for reference: