Background: Coronavirus disease 2019 (COVID-19), which started in Wuhan, China, in late December 2019, was declared a pandemic, infecting more than twelve million people worldwide . Few studies have reported the findings of lung biopsies in COVID-19 . Here, granulomatous inflammation was reported for the first time in COVID-19 lung biopsy . Case presentation: A 54-year-old woman presented to a primary care facility with fever, dry cough, and fatigue . Antibiotherapy was administered for 10 days with the diagnosis of upper respiratory tract infection . However, her condition did not improve and she was admitted to the hospital . In physical examination, crepitant rales were heard in both lungs . Anemia and thrombocytopenia were detected in laboratory tests and she was referred to the hematology clinic . Bone marrow aspiration and flow cytometry showed she had acute myeloid leukemia . Computed tomography-integrated positron emission tomography with a history of previous breast cancer revealed a heterogeneous mass-like lesion in the left lung . The primary malignancy could not be ruled out and tru-cut biopsy was performed . Tests for tuberculosis were negative . Throat swab sample was taken and a real-time polymerase chain reaction confirmed that she had COVID-19 . Radiological findings were evaluated as the progression of COVID-19 pneumonia on computed tomography 6 days after biopsy . Alveolar damage, edema, vascular congestion, mild inflammatory infiltration, type-2 pneumocyte hyperplasia, interstitial fibrosis, early fibrotic changes, fibrinous, organized pneumonia pattern, noncaseating granulomatous inflammation, and desquamation in alveolar epithelial cells were noted in lung biopsy .
Conclusions: There were only a few case reports that described lung biopsy findings in COVID-19 at the time of manuscript preparation . This was the first case of noncaseating granulomatous inflammation described in a COVID-19 case.