Case 260

Medical History

A 37-year-old male patient, unemployed, complained of functional class II dyspnea, adynamia, and dry cough for 6 months. Deny fever, weight loss and smoking. Normal physical examination. Patient was referred to the pulmonology service according to the images presented:

Based on clinical history and imaging findings, what is the most likely diagnosis and what is the next key step in the diagnosis?

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