Correct!
1. Chronic eosinophilic pneumonia usually responds to corticosteroids
Corticosteroids are usually effective in chronic eosinophilic pneumonia raising the possibility that the diagnosis is incorrect (2). His course does not fit well with asthma. He does not have episodic shortness of breath accompanied by wheezing and his pulmonary function tests show restriction rather than reversible obstruction. Furthermore, asthma usually responds to corticosteroids. He is not taking drugs usually associated with drug-induced lung disease. His chest x-ray is not normal with increased interstitial markings at the bases. A thoracic CT may better characterize and define the extent of the interstitial changes and is shown in Figure 2.
Figure 2. Upper panel: movie of the thoracic CT scan (requires Adobe Acrobat). Lower panel: representative static images from the thoracic CT scan.
The CT scan is most compatible with which of the following diseases?