Correct!
4. 1 and 3
The picture is sufficiently complicated that rheumatology consultation is appropriate. The rheumatologist examined the patient and ordered some basic laboratory including an anti SSA and anti SSB which were both positive. Anti Scl 70 and Jo1 were negative. Based on these findings the rheumatologist made a tentative diagnosis of Sjögren’s syndrome.
At the present there are no indications for bronchoscopy.
A thoracic CT scan was ordered and is shown in Figure 2.
Figure 2. Representative images from high resolution thoracic CT scan in lung windows.
Based on the CT scan, the pulmonary function tests, and complaint of dyspnea, what is the most likely diagnosis? (Click on the correct answer to proceed to the fifth and final page)