Review Question - QID 213742

A 68-year-old man presents to the emergency department with dyspnea. He states that it started several days ago and has been gradually worsening. He believes that walking and exertion makes his symptoms worse, and rest relieves his symptoms. Sometimes, he states he has chest pain with deep breaths. The patient generally does not see a doctor and has no known past medical history. He lives alone and works in a warehouse outside of town. He recently had a cold which resolved on its own that he thinks caused these symptoms. He drinks 4 alcoholic beverages daily and has a 44 pack-year smoking history. His temperature is 99.0°F (37.2°C), blood pressure is 174/99 mmHg, pulse is 130/min, respirations are 19/min, and oxygen saturation is 90% on room air. Physical exam is notable for mild wheezes on lung exam. A chest radiograph is performed as seen in Figure A. Which of the following is most likely to be found in this patient?