<s>[INST] I have autoimmune hemolytic anemia (Evans Syndrome).  In Oct. 2010 I developed a cough that would not go away....had a ct scan and found multiple blood clots in both lungs.  In addition they found some "spots" in the right lower lobe of my right lung.  These spots continue to grow.  A needle biopsy was attempted but the radiologist could not reach them with the needle.  Could this be related to Evans syndrome or something unrelated entirely? [/INST] Hello ! Evans syndrome does have increased for thrombosis (blood clots). With your clinical background , the multiple clots in lungs were reported as pulmonary emboli? Was it detected on plain CT or CTPA (CT Pulmonary Angiogram)? CTPA is the best modality to detect pulmonary emboli. Consult a physician and get autoimmune profile tests of blood done - like Anticardiolipin antibody, lupus anticoagulant, Antiphospholipid antibody , beta 2 glycoprotein antibody coz presence of any these is associated with increases risk of abnormal clotting in blood vessels.  Also the spot in the lower lobe of  your right lung can be due to infection or lung tumour.  Kindly consult a chest specialist and take opinion in person . Despite antibiotic and antifungal medications, if the spot continues to grow , it is a concern.  so it is essential to grow for bronchocoscopy and CT guided biopsy of the "growing spot" . Do Consult a chest physician in person at the earliest . </s>