Respiratory Medicine MCQ for NEET PG & FMGE

A 48-year-old woman, diagnosed with right upper lobe tuberculosis (TB) with positive sputum test for Mycobacterium tuberculosis 5 years ago, received 6 months of treatment with isoniazid (INH), streptomycin, and ethambutol (EMB). After sputum conversion to negative for Mycobacterium tuberculosis and significant resolution of lesions, she self-discontinued medication without follow-up. For the past month, she experienced fatigue, and 2 days ago presented with hemoptysis with cough. Chest X-ray shows a large dense shadow with indistinct margins and heterogeneous density in the right upper lobe, with calcification seen in high-density lesions. On lateral view, the lesion is located in the apical-posterior segment of the upper lobe, appearing mass-like (approx. 4cm × 4.5cm) with irregular borders. There is a recent history of TB in a family member. The most likely diagnosis is:

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