<s>[INST] the pulmonologist found something wrong with my lungs he is suggesting an open lung biopsy to determine if it is rhuematory lung, sarcoidosis or basal cell lung cancer. is this test the only tests to detemine which of t he three ? he is leaning toward rhuematory lung disease due to bllod work that shows elevated levels, but the rhuemotologist doesn t think it is such so wont treat me. what other test can be done to determine rhuemotory lung disease? [/INST] Hello! Rheumatoid arthritis is diagnosed based on clinical presentation of inflammatory arthritis involving three or more joints in your body. The blood tests which help in diagnosis are Rheumatoid factor, Anti - CCP (cyclic citrullinated peptide), ESR (Erythrocyte sedimentation Rate) and CRP (C reactive protein). Blood test that helps in diagnosing acidosis is Serum ACE (Angiotensin Converting Enzyme)level. Rheumatoid Arthritis is an autoimmune disease (the body reacts against its own tissues and damages them)so it can affect lungs as well and not just be restricted to your joints.  The various common manifestations of rheumatoid lung are interesting lung disease (OLD), pleural effusion or thickening, inflammation of airways or blood vessels of the lung, rheumatoid nodule. There is also increased risk of respiratory infection due to immunosuppressant Chat Doctor. . Sometimes the  </s>