A 70-year-old woman with a 6-year history of
asthma, a 12-year history of
diabetes mellitus, and who did not
smoke presented to the pulmonology clinic with
dyspnea and
cough. Chest CT performed 5 years earlier for similar symptoms revealed
multiple pulmonary nodules. However, she was lost to follow-up before the work-up was concluded. Otherwise, her medical history was unremarkable. Family history included maternal
endometrial cancer. Physical examination revealed partial oxygen saturation of 98%, respiratory rate of 18 breaths per minute, and heart rate of 77 beats per minute. Her breath sounds and other systemic findings were normal. Pulmonary function test results were as follows: forced expiratory volume in 1 second, 108% predicted (normal range, 80%-120%); total lung capacity, 72% predicted (normal range, 80%-120%); forced vital capacity, 101% predicted (normal range, 80%-120%); diffusing capacity for
carbon monoxide, 69% predicted (normal range, 60%-120%); and forced midexpiratory flow, 85% predicted (normal range, 40%-160%). Complete blood count, erythrocyte sedimentation rate,
C-reactive protein level,
rheumatoid factor, and
antinuclear antibody levels were within normal limits. The patient underwent volumetric thin-section CT of the chest using a multidetector CT scanner (Ingenuity Core 128; Philips Medical Systems) to evaluate lung nodules and pulmonary interstitium.