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What are the two predominate findings on HRCT?
Multiple 1-5 mm centrilobular and peribronchiolar nodules and irregular shaped small lung cysts
What is the distribution of the lung changes?
Upper lobe predominance with sparing of the costophrenic recesses and the anterior right middle lobe and lingular left upper lobe.
What is the most likely diagnosis?
Pulmonary Langerhans cell histiocytosis in a patient with smoking history.
Red arrows point to lung cysts of varying morphology.
Yellow arrows point to peribronchiolar and centrilobular nodules.