29th April 2024

A 72-year-old man, a retired construction worker, presents with a two-year history of progressive shortness of breath on exertion and a chronic dry cough.

A 72-year-old man, a retired construction worker, presents with a two-year history of progressive shortness of breath on exertion and a chronic dry cough. He has a 30-pack-year smoking history. On examination, he has clubbing of his fingers and inspiratory crackles at both lung bases. His chest X-ray shows pleural plaques and bilateral lower zone fibrosis. Pulmonary function tests reveal a restrictive pattern with reduced lung volumes.

Which is the most likely diagnosis?