<s>[INST] context: OPTION A) CT chest shows large bullae in bilateral lung fields diagnostic of emphysema. Also, note the x-ray finding of emphysema which shows tubular appearance of hea and large bullae. A upper lobe involvement B lower lobe involvement C marked airway involvement CT patterns of different type of emphysema. A. Centrilobular emphysema with severe upper lobe involvement in a 68-year-old man with a 70 pack-year smoking history but forced expiratory volume (FEV1) 81% predicted (GOLD spirometry grade 1) B. Panlobular emphysema with diffuse loss of lung parenchymal detail predominantly in the lower lobes in a 64-year-old man with severe a1AT deficiency; and C. Paraseptal emphysema with marked airway inflammation in a 52-year-old woman with a 37 pack-year smoking history and FEV1 40% predicted. OOPTION C) CT FINDING OF ACUTE SILICOSIS This high-resolution computed tomography scanshows multiple small nodules consistent with silicosis but also diffuse groundglassdensities with thickened intralobular and interlobular septa producingpolygonal shapes. This has been referred to as "crazy paving." OPTION D)Pneumonoultramicroscopicsilicovolcanoconiosis is a pneumoconiosis which occurs due to inhalation of fine silica dust found in most volcanoes. [/INST] question: The following CT chest shows the presence of? | options: A: Emphysema B: Aefact C: Silicosis D: Pneumonoultramicroscopicsilicovolcanoconiosis | answer: A </s>