Symptoms A definitive diagnosis can be difficult without invasive testing. Extensive exposure to<unk> s, combined with reduced diffusing capacity, are strongly suggestive of<unk> . Symptoms worsen upon skin exposure to avian proteins in 85% of patients. Symptoms tend to occur or worsen within 4 - 8 hours after exposure to avian protein. Symptoms almost always worsen upon lung exposure to avian protein, and such tests are often performed in hospital in case symptoms become hard to manage. Biochemistry Biochemical results tend to be difficult to pinpoint to<unk> , but can support a diagnosis.<unk>  causes high concentrations of antibodies targeted against avian proteins, although this may also be found in people exposed to avian protein without the disease. These can be detected in a blood test. An inverted CD4+/CD8+ ratio is associated with lymphocytosis. Radiology X-ray or CT scans usually show physical changes to the lung structure (a "ground glass" appearance or a "mosaic" pattern) as the disease progresses. Mediastinal lymphadenopathy and bronchiectasis may also be seen. Precise distribution and types of tissue damage differ among similar diseases, as does response to treatment with prednisone. Up to 12% of x-rays may show no damage, whilst only 2% of CT scans show no damage. Endoscopy Bronchoalveolar lavage typically shows prominent lymphocytosis. This mainly consists of cytotoxic T cells, with an elevated concentration of mast cells. Standard bronchoscopy usually shows chronic inflammation of lung tissue, and granulomas with poorly-defined margins. Lung biopsy usually reveals non-necrotizing granulomatous inflammation. It also shows "foamy" macrophages and crystals of oxalic acid. Hyperplasia tends to occur in type 1 pneumocytes and not in type 2 pneumocytes.
Bird fancier's lung
Farmer's lung
Metsovo lung
Underwood's septa
Saber-sheath trachea
Surfer's knots
World Trade Center lung
Fiddler's neck