Case 33151

Presentation of Case First admission. A forty-five-year-old Lithuanian leather tanner entered the hospital complaining of a chronic cough and blood-streaked sputum.For about six months before admission the patient had had a slight, chronic cough productive of a small amount of white sputum, especially in the morning. Five weeks before entry the cough began to increase, and streaks of rust-colored blood began to appear in the sputum. There was no pain, fever, weakness, sweating or dyspnea. In the two years before admission the weight had risen from 170 to 200 pounds.For many years recurrent bouts of "tonsillitis" had caused . . .