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单选题 患者男性,72岁。9年前开始经常出现咳嗽、咳痰,近1年来症状加重,咳嗽、咳痰喘息,呼吸困难。X线胸片显示肺透亮度增高,膈肌低平。患者1天前在用力大便时突感呼吸困难加重,右胸刺痛。最可能的诊断是

A、 肺气肿
B、 肺栓塞
C、 肺出血
D、 心肌梗死
E、 自发性气胸

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