Teenager with shortness of breath for 1 month

CXR and CT of granulomatosis with polyangiitis
CXR (above left) shows bilateral peripheral airspace disease that is more prevalent in the lower lobes than the upper lobes. Coronal (above right) and axial (below) CT with contrast of the chest better demonstrates the disease distribution and the presence of a few small non-cavitary nodules bilaterally.

The diagnosis was granulomatosis with polyangiitis.