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A 58-year-old woman with a 40 pack-year smoking history presented with several weeks of shortness of breath, chest pain radiating to the back and a hoarse voice. Initial chest X-ray showed a new left upper lobe mass concerning for malignancy. She then underwent positron emission tomography(PET)-CT, which revealed a fluorodeoxyglucose (FDG)-avid left hilar lung mass, (figure 1, red arrow) and left supraclavicular and mediastinal lymphadenopathy (figure 1, orange and green arrows). The PET-CT also showed asymmetric FDG uptake of the vocal folds at the level of the thyroid cartilage …
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