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Pathology
A 46-year-old man has had increasing dyspnea with nonproductive cough for the past year. On physical examination he is afebrile and has clubbing of digits. Pulmonary function testing reveals a mild restrictive abnormality along with reduced DLCO. A transbronchial biopsy is performed and microscopic examination shows numerous alveolar macrophages, plump epithelial cells, mild interstitial fibrosis, and loss of respiratory bronchioles. Lamellar bodies and iron pigment are present within these macrophages. Which of the following is the most likely etiology for his pulmonary disease?
Type I hypersensitivity
Cigarette smoking
Ciliary dyskinesia
Inhalation of mold spores
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