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Previous Volume 357:1239-1246 September 20, 2007 Number 12 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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Presentation of Case

Dr. Allison L. McDonough (Internal Medicine): A 51-year-old man with a history of gastric cancer was admitted to the hospital because of a new pulmonary lesion.

The patient had been in good health until approximately 5 years before admission, when he had a decreased appetite and epigastric discomfort; evaluation at another facility revealed a hiatal hernia, gastroesophageal reflux, and a duodenal ulcer. Testing for Helicobacter pylori was positive. Omeprazole and metoclopramide were administered, and the hiatal hernia was surgically repaired. Pain, persistent gastroesophageal reflux, and weight loss developed approximately 2.5 years before admission. A primary care physician at this hospital . . . [Full Text of this Article]

First Differential Diagnosis

H. pylori Infection and Gastric Cancer

Pulmonary Nodules

Clinical Diagnoses

First Pathological Discussion

Second Differential Diagnosis

Paragonimiasis

Schistosomiasis

Dr. Edward T. Ryan's Diagnosis

Second Pathological Discussion

Anatomical Diagnoses

Source Information

From the Division of Infectious Disease (E.T.R.) and the Departments of Radiology (S.L.A.) and Pathology (R.L.K.), Massachusetts General Hospital; and the Departments of Medicine (E.T.R.), Radiology (S.L.A.), and Pathology (R.L.K.), Harvard Medical School.

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