A 17 years old male patient having history of cough with fever for last few months. On investigation he was having above lung pictures with recurrent left pneumothorax. Now having ICD in situ on left side. What should be provisional diagnosis and line of management?

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Recurrent pneumothorax with cystic lung disease bilateral.... Need further evaluation.... Thoracoscopy pleural biposy, Bronchoscopy with BAL analysis..... Differential diagnosis are cystic lung diseases like Lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (LCH), and lymphoid interstitial pneumonia (LIP).....

Left pneumothorax with ICD in situ. Bilateral pulmonary calcification (Wall calcification of alveoli,bronchi and vessels) Hyperinflation of both lungs. Cardiac shadow is tubular. Metastatic calcification lungs.

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