Correct!
3. The thoracic CT shows multiple non-specific small nodular opacities and basal peribronchial infiltration and bronchiectasis

While several nodules are present on the thoracic CT, the nodules are relatively few in number and somewhat peribronchiolar in distribution, and therefore represent neither diffuse centrilobular nodules nor miliary nodules. Basal fibrotic changes, consisting of peribronchiolar infiltration and bronchiectasis are present, but these findings are not seen within the upper lobes. No thin-walled cystic lesions are present.

Clinical course: The patient was treated periodically for presumed lower respiratory tract infections, with occasional temporary improvement in symptoms, but her symptoms never completely resolved, nor was a causative organism ever isolated. She underwent repeat chest radiography (Figure 4) several months following her initial presentation, which showed similar findings to her two prior chest radiographs (Figures 1 and 2), perhaps with slight worsening of the basal peribronchial thickening.

Figure 4. Repeat chest radiography several months after initial presentation.

Nearly one year following her initial presentation, she complained of persistent, now worsening, symptoms, and underwent repeat chest radiography (Figure 5).

Figure 5. Repeat chest radiography taken nearly one year after initial presentation.

Which of the following statements regarding this imaging study is most accurate? (Click on the correct answer to proceed to the next panel)

  1. The chest radiograph shows improvement in the previously noted bronchovascular thickening
  2. The chest radiograph shows interval development of peribronchial and mediastinal lymphadenopathy
  3. The chest radiograph shows interval worsening of the findings noted previously, now with worsening basal linear opacities and more poorly defined right mid-lung opacity
  4. The chest radiograph shows multiple new thin-walled cystic lesions and cavities
  5. The chest radiograph shows no significant change from prior

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