A 28-year-old woman with a chronic dry cough. CT shows a ‘crazy paving’ pattern and Biopsy reveals noncaseating granulomas. What’s the diagnosis?
A 28-year-old woman presented to the hospital with a 6-month history of dry cough. She was a lifetime nonsmoker and reported no fevers, joint aches, eye pain, or rashes. On physical examination, auscultation of both lower lungs revealed fine crackles. High-resolution computed tomography (CT) of the chest showed mediastinal lymphadenopathy and diffuse ground-glass opacities (left, axial view). Also visible were areas of superimposed interlobular and intralobular septal thickening, a pattern known as crazy paving (left, box). A subsequent transbronchial lung biopsy showed multiple noncaseating granulomas (middle, inset showing granuloma; hematoxylin and eosin stain). Bronchoalveolar lavage cultures, histopathological analysis, and molecular testing were negative for infectious organisms, including Mycobacterium tuberculosis. Which of the following is the most likely diagnosis?
