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A pleural mass with pulmonary infiltrates
  1. C J Ryerson1,
  2. S Malhotra1,
  3. S Lam1,
  4. J C English2,
  5. D N Ionescu2
  1. 1Department of Respiratory Medicine, Vancouver General Hospital,Vancouver, Canada
  2. 2Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, Canada
  1. Correspondence to:
    Dr Chris Ryerson
    Department of Respiratory Medicine, Gordon & Leslie Diamond Health Care Centre, 2775 Laurel St, Vancouver General Hospital, Vancouver, Canada V5Z 1M9; cryerson{at}interchange.ubc.ca

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Clinical presentation

A healthy 34-year-old woman had a 1-month history of dyspnoea and an abnormal chest radiograph. A course of erythromycin was unhelpful. Further details of her history did not suggest an aetiology. Physical examination showed only mild hypoxia on exertion.

A high-resolution chest CT scan was performed, revealing a left apical and hilar mass extending posteriorly to encase the lung, particularly along the mediastinal aspect (fig 1). There was also bilateral airspace opacification in a bronchocentric distribution. Bronchoscopy and thoracentesis were non-diagnostic.

Figure 1

 Coronal CT scan of the chest showing ground glass and dense airspace opacification in a bronchocentric distribution throughout both lungs. There is also left hilar enlargement and multiple pleural masses.

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