Case 23--New Lung Nodule in an Elderly Smoker

Clinical summary: A 76-year-old man, who was being followed in the geriatric clinic, had a routine chest radiograph in 7/98 that showed a new, right upper lobe nodule not present one year before. CT was suspicious for malignancy. He had a history of active osteoarthritis. Remote tuberculosis had been treated with collapse therapy on the left. He had a prostatectomy for cancer in 1988 and repair of an abdominal aortic aneurysm in 1993. He served in the infantry in WWII and worked around industrial machinery but denied exposure to asbestos. Physical examination showed a thin man who appeared well. There was no cervical or supraclavicular adenopathy. Examination of the chest was normal. PFTs showed an FEV1 of 2.75 L. Bronchoscopy showed no lesion, and lavage fluid did not show tumor cells. The nodule was resected in 8/98.

Radiology | Gross specimen | Image 1 | Image 2 | Image 3 | Image 4 | Image 5 | Discussion

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