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A 35-year-old man was admitted to the hospital because of increasing exertional dyspnea, recent arthralgia and digital clubbing, and a questionable fungus ball in the right lung.
The patient had been well until five years earlier, when he began to have increasing exertional dyspnea. Four months before admission arthralgia developed, and his mother, who had pulmonary emphysema, observed that he had digital clubbing. Two months later he consulted a physician. Radiographs of the chest (Figure 1) showed hyperinflated lungs and bilateral upper-lobe bullae; there was a lobulated soft-tissue mass with an air-fluid level within a large bulla in
Differential Diagnosis
Clinical Diagnosis
Dr. Melvin D. Burton's Diagnoses
Pathological Discussion
Anatomical Diagnoses
References
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