A 55-Year-Old Man Comes to the Office Due to Malaise

A 55-year-old man comes to the office due to malaise and cough over the past 2 months.  He describes yellow sputum production with occasional streaks of blood.  The patient smokes a pack of cigarettes daily and has a history of alcohol use disorder with prior episodes of binge drinking.  Temperature is 37.1 C (98.8 F) .  Examination shows poor dentition with dental caries, gingivitis, and enlarged submandibular lymph nodes.  Coarse rhonchi are heard during auscultation of the right lung.  Chest CT scan reveals an extensive right lung consolidative process with air bronchograms.  Bronchoscopy is performed, and a lung biopsy specimen shows the findings in the image below. Which of the following is the most likely diagnosis?

A) Actinomycosis
B) Adenocarcinoma
C) Mucormycosis
D) Sarcoidosis
E) Tuberculosis

Correct Answer:

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