What diagnostic considerations can be done?
These appearances could be due to RB-ILD and possibly desquamative Interstitial pneumonia, especially in a heavy smoker. Subacute hypersensitivity pneumonia is also likely to this man who, was discovered later to keep birds as a hobby. The nodular distribution and the lack of fissural nodularity make sarcoidosis less likely.
Small non calcified mediastinal nodes are present.
Both lungs show changes of diffuse centrilobular nodular infiltration in both lungs.
Also, there are more confluent areas of ground glass opacification present.
Features of mosaic attenuation are noted.
Normal pleural spaces and pericardium.