The radiographic examination of the thorax does not reveal specific findings
underlying the current clinical presentation.
Even though the interstitial pulmonary infiltrate carries the potential of the entire
spectrum of infectious pneumonia – including viral, bacterial and fungal – the potential
of bacterial, mycobacterial and fungal microorganisms being the underlying issue here
is rather low because of the mild degree of changes and the lack of mediastinal lymph
node involvement.
The potential for this being neoplastic is also considered very low. However, screening for fungal microorganisms is indicated since some fungi species –
such as histoplasmosis spp. – tend to present with multifocal mineralized granulomas,
which is a possible differential of the pulmonary osteomas here.
Bronchoscopy with BAL should be considered for further definition in case the
pending test results are equivocal and the patient is refractory to symptomatic
treatment.