Review Question - QID 217132

A 45-year-old man presents to urgent care with 2 weeks of worsening shortness of breath, right-sided chest pain that is worsened with inhalation and exhalation, and a productive cough with occasional streaks of blood. His medical history is unremarkable. He recently immigrated from Indonesia and has smoked 1 pack of cigarettes per day for 10 years. He drinks alcohol socially but does not use any other drugs. He does not take any medications currently except for ibuprofen as needed. His temperature is 101.2°F (38.4°C), blood pressure is 95/65 mmHg, pulse is 110/min, and respirations are 20/min. Lung examination is significant for left upper lobe crackles. A chest radiograph shows hilar lymphadenopathy along with a left upper lobe consolidation. Laboratory studies show:

Serum:
Na+: 128 mEq/L
Cl-: 103 mEq/L
K+: 5.4 mEq/L
HCO3-: 17 mEq/L
BUN: 12 mg/dL
Glucose: 65 mg/dL
Creatinine: 0.97 mg/dL
Cortisol (8 AM): 1 µg/dL
Adrenocorticotropic hormone (8 AM): 100 pg/mL (normal 10-60 pg/mL)

Which of the following is the most likely diagnosis?