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Answer to diagnostic dilemma

        The biopsy specimen (Figure 1) showed bronchiolitis obliterans organizing pneumonia (BOOP). The patient was started on a regimen of high-dose prednisone, 60 mg orally per day, in addition to oxygen. His clinical improvement was steady but slow over the next 3 months. At the end of 3 months, he was placed on a tapered regimen of steroids and weaned from oxygen.
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