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Bilateral ill-defined nodular opacities throughout both lungs with more confluent consolidation in the left upper lobe is evident. Several of the nodules have apparent central lucency which is suspicious for cavitation. The lung volumes are reduced. There is no pleural fluid and the cardiac and mediastinal contour is normal.
COP may explain the reduced volume lungs and more peripheral confluent areas of consolidation, particularly in the left upper lobe. The possibility of cavitating nodules is however not easily explained and in the immunocompromised patient consideration to invasive aspergillosis or other atypical infections should be given.