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A 54-year-old female presented with chronic dry cough and dyspnoea over 3 months and was referred to our outpatient clinic. She had no history of smoking, allergy or respiratory disorders. Chest X-ray demonstrated bilateral upper lung predominant consolidation (figure 1A). Chest CT revealed extensive upper lobe predominant subpleural consolidation with air bronchograms as well as extensive ground glass opacities (GGOs) with intralobular septal thickening (figure 1B–D). Mediastinal lymphadenopathy in stations 4R and 10R with no calcification was observed. There were no crackles on auscultation with oxygen saturation of 95% on room air despite a wide range of abnormal shadows on chest X-ray and CT. Based on the available clinical and radiographic findings, the differential diagnosis encompassed pulmonary sarcoidosis, malignant lymphoma, bronchoalveolar carcinoma, lymphangitis carcinomatosa and amyloidosis.
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