6 Patterns > Minimal Changes
Minimal Changes
You have selected the minimal changes pattern!
Patients with minimal changes present with a variety of clinical signs and symptoms. If your has minimal changes, close pathologic investigation of the small airways and vasculature is required. In addition, these cases often require clinical and radiologic correlation before a diagnosis can be made. If you still think you have a minimal change pattern biopsy, click the link below.
If you're still unsure if you're dealing with a minimal change pattern, explore other histologic features below.
Normal wedge biopsy from a patient with a lung mass.
Normal broncovascular bundles, no fibrosis, no inflammation, no airspace filling.
Subtle Airway Abnormalities
Airway abnormalities are the most often abnormality in the setting of a minimal change biopsy. The mucostasis can be observed from low-power.
Bronchovascular Bundle
The pulmonary artery and bronchiole run in parallel at the center of the pulmonary lobule. Each artery should have a paired airway. The diameter of each should be equivalent.
If your biopsy has the above features, you are in the appropriate category of minimal change. But your job is not complete by recognizing fibrosis.
Sample Signout
If no additional specific histologic features are identified, consider the following approach to signing the case out:
Generous biopsy showing minimal pathologic changes (see comment).
Comment: The biopsy shows minimal pathologic changes. This is seen most commonly in the setting of small airways disease and the clinical syndrome of constrictive bronchiolitis. The differential diagnosis also includes vascular abnormalities, cystic lung disease, and sampling error. Correlation with imaging studies, serology, microbiology studies, and clinical history is suggested.