Case 31--Recurrent Pulmonary Nodule and Other Similar Cases

Clinical summary: A 73-year-old man, who was being followed in the chest clinic for a right lower lobe nodule, underwent further diagnostic evaluation in 10/99 because the nodule had increased in size. Two years previously, a chest radiograph obtained to evaluate a history of asbestos exposure in construction work demonstrated a nodule in the RLL. At the current visit, he was asymptomatic and denied cough, dyspnea, fever, night sweats, or weight loss. He has traveled in Texas and through the Central Valley of California. Past medical history includes a wedge resection in 1991 for a pulmonary nodule, and active, seropositive rheumatoid arthritis. Medications include plaquenil, prednisone, sulfasalazine, colchicine, elavil, hydrochlorothiazide, ibuprofen, and calcium. On examination, vital signs were normal. Oxygen saturation was 96% on air. Cardiac, lung, and abdominal examinations were normal. The proximal interphalangeal, knee, and ankle joints were warm and swollen.

Laboratory tests: WBC 7.5 k/µl with PMNs 5.5 k/µl, hematocrit 39.2%, platelets 223 k/µl.

Radiology | Image 1 | Image 2 | Image 3 | Case 2 | Case 2 p.2 | Case 2 p.3 | Case 3 | Case 3 p.2 | Case 3 p.3 | Case 3 p.4 | Case 4 | Case 4 p.2 | Case 4 p.3 | Case 4 p.4 | Discussion

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