Table 1 Lung-related investigations

High-resolution computed tomography (HRCT) of the chest

(T0—time of first development of dyspnea)

Reticular opacities in:

-Posterior segment of right upper lobe

-Superior segment of right lower lobe

-Apicoposterior segment of left upper lobe

Two irregular soft tissue nodules in superior segment of right lower lobe

Suggestive of old healed granulomatous infection

High-resolution computed tomography (HRCT) and contrast-enhanced computed tomography (CECT) of chest

(T0 + 2 years)

Multiple reticular nodular opacities in:

-Posterior segment of right upper lobe

-Superior segment of right lower lobe

-Left superior lingular lobe

Thickening of the horizontal fissure on the right side

No lung masses or cavitatory lesions

Pretracheal, right paratracheal, and bilateral hilar lymphadenopathy (largest: 2 cm at right hilum)

Suggestive of a chronic granulomatous disease of lung

? Sarcoidosis? Tuberculosis

CECT chest and abdomen

(T0 + 3 years)

Extensive bilateral diffuse centrilobular tree in bud opacities predominantly in:

-Right lower segment of upper lobe

-Upper segment of right lower lobe

Associated with fibrotic changes and horizontal fissure thickening

Diffuse ill-defined hypodense lesions without arterial phase enhancement in bilateral kidneys

-Left lesion is in the mid pole: 3 cm × 4 cm × 5 cm

-Right lesion is in the lower pole: 3.5 cm × 3.5 cm × 4 cm

Mantoux (T0 + 3 years)

Negative

Sputum for GeneXpert

(cartridge based nucleic acid amplification test for diagnosis of tuberculosis)

(T0, T0, + 2 years T0 + 3 years, T0 + 3 years)

Negative

(Four times over 4 years)

BAL Gene Xpert (T0 + 3 years)

Negative

Endobronchial ultrasound (EBUS)-guided lymph node biopsy and bronchial wash

(T0 + 3 years)

Reactive lymphoid proliferation

Lung function tests

(T0 + 3 years)

Restrictive