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A correction has been published: N Engl J Med 2009;361(15):1516.

Case Records of the Massachusetts General Hospital
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Volume 360:1886-1895 April 30, 2009 Number 18
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Case 14-2009 — A 36-Year-Old Man with Chest Pain, Dysphagia, and Pleural and Mediastinal Calcifications
Henning A. Gaissert, M.D., Nitra Piyavisetpat, M.D., and Eugene J. Mark, M.D.

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Presentation of Case

A 36-year-old man was admitted to the hospital because of chest pain, dysphagia, dyspnea, and pleural and mediastinal calcifications.

He had been well until approximately 6 years before admission, when a 182-kg weight fell on his shoulders while he was lifting weights at a gym. Intermittent left-sided chest pain occurred thereafter, gradually increased in severity, and responded transiently to nonsteroidal antiinflammatory medications and ice packs. Two and a half years before admission, dysphagia developed in association with solid foods and gradually increased in severity to include liquids; he lost 4.5 kg in weight. An esophagogram reportedly showed minimal tertiary contraction . . . [Full Text of this Article]

Differential Diagnosis

Systemic Disorders with Pleural Calcification

Diseases of the Chest Associated with Calcification

            Parenchymal Lung Diseases

            Mediastinal Diseases

Diseases of the Chest Wall

            Non-Neoplastic Conditions

            Osteosarcoma

            Mesothelioma

Summary

Dr. Henning A. Gaissert's Diagnosis

Pathological Discussion

Anatomical Diagnoses


Source Information

From the Departments of Thoracic Surgery (H.A.G.), Radiology (N.P.), and Pathology (E.J.M.), Massachusetts General Hospital; and the Departments of Surgery (H.A.G.), Radiology (N.P.), and Pathology (E.J.M.), Harvard Medical School.

This article (10.1056/NEJMcpc0900637) was updated on October 7, 2009, at NEJM.org.




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