Abstract

70-year-old woman was referred to the pulmonary clinic for the evaluation of multiple pulmonary nodules that had been noted on a routine surveillance CT scan performed after a diagnosis of breast cancer. On presentation to the pulmonary clinic, she denied symptoms, including dyspnea, hemoptysis, weight loss, fevers, chills, or night sweats. She did report a dry, nonproductive cough of several months duration. The patient’s medical history was significant for stage 1 (T1bN0M0) infiltrating breast carcinoma that had been diagnosed approximately 1 year prior to the current presentation. Treatment had consisted of a lumpectomy, and negative surgical margins were achieved. The patient declined radiation therapy and was given therapy with anastrazole. The patient also reported a history of hypertension, hyperlipidemia, peripheral vascular disease, and collagenous colitis. Prior surgeries included the recent lumpectomy, an appendectomy, carotid endarterectomy, and a total abdominal hysterectomy. Her medications included mesalamine, simvastatin, lisinopril, atenolol, clopidogrel, and anastrazole. The patient had no notable travel history. She had a 15-pack-year smoking history, but had quit 13 years prior.

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