Endobronchial biopsy from case 2 showing sheets of epitheloid macrophages without giant cells, mixed with other chronic inflammatory cells. Endobronchial biopsy from case 2 showing sheets of epitheloid macrophages without giant cells, mixed with other chronic inflammatory cells. Staining for alkali and acid-fast bacteria and fungi were negative. There was no evidence of invasive neoplasia and the final culture was negative. S. Bloch et al. Eur Respir Rev 2009;18:295-299 ©2009 by European Respiratory Society