50F

h/o rheumatoid arthritis, LTBI s/p treatment, dx COP on VATS bx

Recent COVID

improved on Pred + embril, with subsequent recurrence of arthritis and ILD, now on cellcept, Rinvoq (d/c)

Now prednisone, humira

Path from 5 years ago

Surgical Pathology
A.  RIGHT MIDDLE LOBE:
SEGMENT OF LUNG PARENCHYMA WITH PROMINENT DEPOSITION OF ANTHRACOTIC PIGMENT, MILD EMPHYSEMATOUS CHANGES AND FOCAL MILD PLEURAL FIBROSIS.
NO ACTIVE INFLAMMATION OR INTERSTITIAL FIBROSIS NOTED.

B.  RIGHT UPPER LOBE:
LUNG PARENCHYMA WITH LIMITED MILD CHRONIC INFLAMMATION, ANTHRACOTIC PIGMENT DEPOSITION AND MILD EMPHYSEMATOUS CHANGES.
THERE IS CHRONIC INFLAMMATION FOCALLY SURROUNDING THE TERMINAL BRONCHIOLES ASSOCIATED WITH MILD INTERSTITIAL FIBROSIS.
THE HISTOLOGIC FINDINGS OVERALL ARE MILD AND NON-SPECIFIC.

C.  RIGHT LOWER LOBE:
SEGMENT OF LUNG PARENCHYMA WITH CONSOLIDATION OF AIR SPACES BY CHRONIC INFLAMMATORY CELLS AND MACROPHAGES.
THERE IS PROMINENT CHRONIC BRONCHIOLITIS AND CHRONIC PERIVASCULAR CHRONIC INFLAMMATION.
SCATTERED MASSON BODIES ARE ADMIXED WITH THE INFLAMMATORY INFILTRATE IN KEEPING WITH AN ORGANIZING PNEUMONIA (CRYPTOGENIC ORGANIZING PNEUMONIA).