20th February 2025

A 70-year-old retired plumber presents with ongoing shortness of breath and fatigue.

A 70-year-old retired plumber presents with ongoing shortness of breath and fatigue. Past medical history includes BPH, aortic stenosis and atrial fibrillation. His medications include tamsulosin and apixaban. He has no allergies. He is an ex-smoker of 30 pack years. He lives alone and has a pet parrot. 

His CXR shows a reticular pattern of fibrosis worse in the upper lobes accompanied by some volume loss. Lung function reveals a mixed obstructive/restrictive spirometry picture.

What is the most likely diagnosis?

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