A diagnosis of seclusion

Abstract

A 40-yr-old female was seen in the rapid-access chest clinic with a 4-month history of dry cough, mild dyspnoea and left chest discomfort, which seemed to have started during a holiday to a sunny European country. Antibiotics given by her primary care physician had not helped. The patient was an ex-smoker (10 pack-yrs, having given up 14 yrs previously). There were no significant comorbidities A chest radiograph (CXR) was performed (fig. 1). Figure 1 Chest radiograph ### Task 1 What does the CXR demonstrate? 1. Cardiomegaly and Kerley-B lines. 2. A right pleural effusion. 3. A density overlying the left hilum. 4. A nodule in the left upper lobe. ### Answer 1 The correct answer is c). The CXR demonstrated a density overlying the left hilum. The patient underwent a computed tomography (CT) scan, which showed a soft-tissue mass in the lower left lobe without any effusion, lymphadenopathy or other distant disease (fig. 2). A …