Correct!
2. The thoracic CT shows impacted airways in the left lower lobe
The thoracic CT shows the tubular-shaped opacities within the left lower lobe. When a tubular shape is encountered at thoracic CT, two main diagnostic considerations present themselves- an abnormality involving an airway or an abnormality involving a vessel. In this case, a vascular etiology is excluded because the vessels in the left lower lobe show normal size. An arteriovenous malformation can only be diagnosed at thoracic CT when the artery leading to the vascular nidus, and the vein draining the nidus, are enlarged, and such is not the case here. Similarly the attenuation characteristics of the opacities on the soft tissue windows are not consistent with a vascular etiology, which excludes pulmonary artery aneurysm or varix. The tubular morphology is consistent with an airway etiology, and the absence of normal bronchi in the vicinity of the tubular opacities suggests that these opacities indeed represent impacted bronchi. There is no evidence of cystic disease or air-fluid levels in the left lower lobe, and, as reviewed previously, the imaging characteristics are not consistent with consolidation.
What is the appropriate next step for the evaluation / management of this patient?