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Pulm PEEPS
@pulmpeeps.bsky.social
Our mission is to provide multiple formats for learners to learn pulmonary and critical care medicine 🫁 Co-founders @KMonty_MD and @david_furfaro
Some infographics applicable to yesterday's episode here. Listen in for some more pearls!

www.pulmpeeps.com/2025/10/01/1...
October 2, 2025 at 4:32 PM
This was an unusual case, and thinking about tuberculosis first is the right diagnostic approach. However, this case does illustrate:
1) Not all miliary patterns are TB

2) The importance of maintaining a high index of suspicion, and confirming diagnoses
October 2, 2025 at 4:32 PM
The patient was only getting worse after starting empiric TB treatment. A bronchoscopy with EBUS biopsy was pursued to get cultures, resistance pattern, and diagnostic clarity.

This showed metastatic pulmonary adenocarcinoma.

He was started on chemo with dramatic response 👇
October 2, 2025 at 4:32 PM
Listen to our latest episode to hear more about working through this differential, the ultimate diagnosis, and some clinical pearls along the way

www.pulmpeeps.com/2025/10/01/1...

@pulmcrit.bsky.social @pulmtoilet.bsky.social @atscommunity.bsky.social @lancetrespirmed.bsky.social
107. Fellows’ Case Files: University of Kansas Medical Center KUMC | PulmPEEPs
www.pulmpeeps.com
October 1, 2025 at 10:22 AM
And some other imaging to help with your diagnostics.

What is on your differential for this patient?? What next steps are you taking?
October 1, 2025 at 10:22 AM
Pathology is consistent with a non-caseating granuloma.

Imaging and pathology were consistent with sarcoidosis and after negative work-up for alternative causes. The patient will follow-up with outpatient pulmonary for sarcoidosis management. Don't forget about the Sarcoid 1-2-3 sign!
September 25, 2025 at 10:13 AM
What do you think the diagnosis is based on this histopathology?
September 25, 2025 at 10:13 AM