Case -T9-2B PULMONARY FUNCTION STUDY

Essay

Case
-T9-2B PULMONARY FUNCTION STUDY
LOCATION: Outpatient, Hospital
PATIENT: Duane Scholl
PHYSICIAN: Gregory Dawson, MD
ENTRANCE DIAGNOSIS: Sarcoidosis, a nonsmoker, and gave good consistent effort
INTERPRETATION:
1. Flow volume loop has mild concavity toward the volume axis, well-preserved inspiratory limb, and reduced flow rates.
2. No significant change after bronchodilator.
3. Lung volumes are normal, without evidence of hyperinflation.
4. Single breath lung volumes are also normal, without hyperinflation.
5. There is no significant dynamic airway collapse (air trapping).
6. Transfer factor is quite reduced (to 52% of predicted), suggesting reduced alveolar capillary membrane surface area and/or V/Q mismatching.
7. Pre-bronchodilator flow rates have a pattern consistent with mild chronic obstructive pulmonary disease/emphysema.
8. Post-bronchodilator values show no significant change, and the same conclusion can be reached.
9. The MVV (maximum voluntary ventilation) is abnormal pre-bronchodilator and normal post-bronchodilator. Between that and a normal FEV1 (forced expiratory volume in one second), I expect a reasonably normal exercise tolerance.
10. Airway resistance is normal.
OVERALL IMPRESSION: Borderline lung volumes with slightly reduced DLCO (diffuse capacity of lungs for carbon monoxide) are consistent with diagnosis of sarcoid. Comparing this to studies done in the past, the DLCO at this time is just a little bit better than the one in October, slightly better than the one done in August, better than the one done in May of this year, and actually similar to what it was in April of this year. The plethysmographic TLC (total lung capacity) is almost identical to what it was in May of last year and slightly less than it was in October of this year. I do not think there is any significant change.
T9-2B:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________