A 53-year old male presented with progressively worsening dyspnoea, cough and intermittent haemoptysis. History Patient complained of nasal dryness ongoing for over for 5 months He received multiple courses of oral antibiotics for community-acquired pneumonia but did not get any relief. Patient reported a frequent application of petroleum jelly to his nostrils in order to relieve the symptoms of nasal dryness. Observation Signs of cachexia Productive cough with mucoid sputum Shortness of breath on exertion No overt signs of respiratory failure Physical examination Reduced air entry on right with bronchial breathing in the right middle zone.
Investigations Chest X-ray- Right middle lobe consolidation was observed. High-resolution CT was advised (HRCT images provided). Bronchoscopy- transbronchial biopsies were taken for cytology. Biopsy revealed lipid macrophages and interstitial…