Fibrotic nodules in both lungs

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A 62-year-old mason complains of shortness of breath, which has become progressively worse during the past year. A chest X-ray shows small nodular shadows in both lungs. Pulmonary function studies reveal a pattern consistent with restrictive lung disease. The patient subsequently develops congestive heart failure and expires. Autopsy discloses numerous small, fibrotic nodules in both lungs. Histologic examination of these nodules is shown in the figure. Which of the following is the most likely diagnosis?

  1. Anthracosis
  2. Asbestosis
  3. Sarcoidosis
  4. Silicosis
  5. Wegener granulomatosis