Case 262

Medical History

A 31-year-old male patient sought outpatient care for persistent chest pain, accompanied by dry cough and mild evening fever, associated with night sweats, malaise, inappetence, fatigue and moderate weight loss, for three months. He claims to be asthmatic, but denies smoking and alcoholism. He received adequate empirical treatment for tuberculosis, without clinical improvement. Laboratory tests: hemogram - leukocytosis (13,300 / mm3) and elevated eosinophilia (49%); negative sputum smear microscopy and negative anti-HIV serology. Chest X-rays were requested in two incidences.

Based on clinical history, laboratory and imaging tests, which is the most likely diagnosis?

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