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Previous Volume 356:873-874 February 22, 2007 Number 8 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Robertson et al. (Nov. 2 issue)¹ discuss the case of a young man with exertional dyspnea, cough, and increasing pain in the right lower quadrant, which was traced to a subcutaneous nodule. Instead of thoracentesis, computed tomography of the chest, abdomen, and pelvis and bronchoscopy, would a more straightforward and less invasive approach have been to perform a biopsy of the subcutaneous nodule? This approach would have offered the same diagnosis — acute paragonimiasis — at less expense and risk to the patient.

Russell R. Ryan, M.D.
Surgical Specialists of the North Shore
Salem, MA 01970

1. Robertson KB, Janssen WJ, Saint S, Weinberger SE. The missing piece. N Engl J Med 2006;355:1913-1918. [Free Full Text]

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