This 34 year old female presented for evaluation with 2 months of increasing shortness of breath, chest tightness and cough. There was minimal sputum production, but she is uncomfortable at night and had to sleep with 2 pillows. Wheezing had been present but she did not respond to steroids, albuterol or Symbicort. Her lab data was normal except for a positive mono test. She was not exposed to any aerosols. She is a non-smoking, non-drug using female with 2 children living in a rural enviroment.
The CT images are shown:
What are possible diagnoses and how would proceed at this time