Article Text
Chest clinic
Pulmonary puzzle
A rapidly growing lung mass with air crescent formation
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- Allergic Alveolitis
- Interstitial Fibrosis
- Sarcoidosis
- Anca-Related Vasculitides
- Asbestos-Induced Lung Disease
- Bronchiectasis
- Drug-Induced Lung Disease
- Pulmonary Eosinophilia
- Pulmonary Vasculitis
Pulmonary puzzle
A 58-year-old man who never smoked and was under follow-up for polymyositis associated with fibrotic interstitial lung disease was found to have an incidental opacity in the right upper lobe on a chest radiograph. He had been treated with daily azathioprine 200 mg and prednisolone 10 mg for 15 years. A CT chest revealed a mass-like lesion of relatively low attenuation suggesting necrosis (figure 1). Bronchoalveolar lavage was negative for microbiology and cytology. CT-guided biopsies were reported as showing necrosis and inflammation only. A month later, he developed cough with malodorous sputum, generalised fatigue, mild fevers, sweats and dyspnoea.
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