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A 52-year-old woman was admitted to the hospital because of cough and dyspnea.
She had smoked two to three packs of cigarettes daily for 35 years. During the two decades before admission, she had been treated for many episodes of pneumonia, often designated as "atypical." Her treatment over the years had included antibiotics as well as adrenocorticosteroids for bronchospasm. The earliest chest radiographs showed a slight increase of the interstitial markings bilaterally, but no focal parenchymal disease; the heart size was normal.
Nine years before the current admission, the patient had been admitted to this hospital for the first time
Differential Diagnosis
Clinical Diagnosis
Dr. Walter J. O'Donnell's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Pulmonary and Critical Care Unit, Department of Medicine (W.J.O., R.L.K.), and the Departments of Pathology (R.L.K.), Psychiatry (A.E.E.), and Radiology (C.W.), Massachusetts General Hospital; and the Departments of Medicine (W.J.O., R.L.K.), Pathology (R.L.K.), Psychiatry (A.E.E.), and Radiology (C.W.), Harvard Medical School.
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