20th February 2025

A 68-year-old patient is referred to respiratory clinic for assessment of his dyspnoea and cough.

A 68-year-old patient is referred to respiratory clinic for assessment of his dyspnoea and cough. He is a current smoker and reports no exposure to asbestos. He does not have any pets.

An HRCT is performed which shows centrilobular nodules, ground glass change and airway wall thickening with marked centrilobular emphysema. A lung biopsy is analysed and shows accumulation of pigmented macrophages in terminal bronchioles.

What pattern of disease is this likely to represent?

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