16th February 2025

A 55-year-old male poultry worker with a BMI of 42 presents to the respiratory clinic with a long history of progressive breathlessness and fatigue, which has worsened over the last few months.

A 55-year-old male poultry worker with a BMI of 42 presents to the respiratory clinic with a long history of progressive breathlessness and fatigue, which has worsened over the last few months.

FEV1: 1.4 L (predicted: 3.9 L)

FVC: 1.8 L (predicted: 5.1 L)

KCO: 0.6mmol/min/kPa/L (normal range 0.99 – 2 mmol/min/kPa/L)

CT chest: small centrilobular nodules in the upper and middle lobes and ground-glass changes

What is the most likely cause of his symptoms?

Select the SINGLE most appropriate option from the list below. Select ONE option only.