Case 42-1991

Presentation of CaseA 63-year-old woman was admitted to the hospital because of a question of a tumor of the right lung.The patient was in stable health until one year earlier, when a dry cough developed. An x-ray film of the chest, obtained elsewhere, was reported to be normal. The cough soon disappeared. Eight months before admission a nonproductive cough recurred and persisted, and the patient experienced exertional dyspnea. Four months later she began to have pleuritic pain at the upper border of the right scapula. Two months before entry, when she traveled to New Mexico, the pleuritic pain . . .