Abstract

A 74-year-old man was admitted to our hospital after presenting with fever, nonproductive cough, and a 2-month history of enlargement of the left breast. Examination showed gynecomastia on the left side (Panel A) with bilateral crepitations of the lung. Computed tomography (CT) of the thorax showed a left-chest-wall collection of fluid with erosion of the ribs and extension into the pleural space, anterior mediastinum, and lung parenchyma (Panel B and Panel C, arrows). There were also bilateral nodular infiltrates, a right pleural effusion, and enlarged mediastinal lymph nodes. Fluid obtained from the left chest wall by means of fine-needle aspiration . . .

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