Diagnostic Procedures

Diagnostic Procedures:

• Blood chemistry tests and cell counts.
• Analysis of urine, both chemistry and microscopic.
• Imaging tests such as x-ray, MRI, and CT scan, which show lung infiltrates or nodules typical of granulomatosis or vascular tissue damage.
• A CT virtual bronchoscopy can help identify stenosis and larynx problems.
• Digital subtraction angiograpy (DSA) may be useful in identifying stenosis or other abnormalities caused by vasculitis.
 

Biopsy:

Biopsy of the suspected granuloma and/or blood vessels or other affected tissues.

A biopsy is a small tissue sample that is examined by a pathologist for abnormalities. Some things to be aware of:

1. Biopsies are usually done under local anesthetic, excepting for open lung biopsies which require a general anesthesia.

2. Negative sinus biopsies are notoriously unreliable because it is such a problem to get the correct tissue sampled.

3. Kidney biopsies are generally rather trouble free and involve minimal intrusiveness if done by the guided-needle method.

4. Lung biopsies may be either by guided-needle or an open-lung surgical method. The open lung is major surgery and probably to be avoided if possible.

5. Some physicians insist on an open lung biopsy. It might be best to get a second opinion on the necessity for that method before proceeding.

6. More than once, a lung granuloma as been incorrectly identified as lung cancer. It may be prudent to have the tissue sample submitted to a different pathologist in a different hospital for evaluation.

Biopsies may be required of tissues where there is persistent inflammation problems in one or more of the following organs, as listed below starting with the most frequent:
Sinus, nose, ear, throat, lung, joints, fever, kidney, trachea, eye, skin, peripheral nerves, inflammation of the heart lining, central nervous system, and very rarely heart, pancreas, spleen, prostate, liver, testicles.