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Figure 1. A 62-year-old man with end-stage renal disease from hypertensive nephrosclerosis that had been treated by hemodialysis for 14 years presented to the emergency room with a productive cough and fever, from which he recovered. A chest film showed right hilar prominence and pleural-based masses (arrows in Panel A), with destructive changes in the adjacent ribs on the left. The cardiac silhouette, pulmonary vasculature, and position of a LeVeen shunt placed for recurrent dialysis-associated ascites were unchanged from a previous chest film. Computed tomography of the chest showed mild mediastinal adenopathy and multiple expansile lytic lesions of the . . . [Full Text of this Article] |