Case 405

Medical history

Woman, 31 years-old, attends to pneumologist appointment complaining of dyspnea, fatigue and cough for four months, with progressive worsening of the symptoms. Diagnosis of asthma in the childhood, with intense crisis and 3-times history of pneumonia in the last year. Denies smoking. Started asthma treatment and requested a chest X-ray, that showed an atelectasis zone in the middle lobe of the right lung. At follow-up, there was an improvement in dyspnea and cough, but with the persistence of respiratory wheezes in the right lung during auscultation. Requested chest CT and bronchoscopy.

According to the clinical history, physical examinations and image findings, which is the most likely diagnosis for this patient?

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