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A diagnosis of seclusion

P. Beckett, F. Chishti, D. Waller
Breathe 2010 7: 189-191; DOI: 10.1183/20734735.006410
P. Beckett
1Burton Hospitals NHS Foundation Trust, Burton-on-Trent,
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  • For correspondence: paul.beckett@burtonh-tr.wmids.nhs.uk
F. Chishti
1Burton Hospitals NHS Foundation Trust, Burton-on-Trent,
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D. Waller
2Glenfield Hospital, Leicester, UK
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Case history

A 40-yr-old female was seen in the rapid-access chest clinic with a 4-month history of dry cough, mild dyspnoea and left chest discomfort, which seemed to have started during a holiday to a sunny European country. Antibiotics given by her primary care physician had not helped. The patient was an ex-smoker (10 pack-yrs, having given up 14 yrs previously). There were no significant comorbidities A chest radiograph (CXR) was performed (fig. 1).

Figure 1

Chest radiograph

Task 1

What does the CXR demonstrate?

  1. Cardiomegaly and Kerley-B lines.

  2. A right pleural effusion.

  3. A density overlying the left hilum.

  4. A nodule in the left upper lobe.

Answer 1

The correct answer is c).

The CXR demonstrated a density overlying the left hilum. The patient underwent a computed tomography (CT) scan, which showed a soft-tissue mass in the lower left lobe without any effusion, lymphadenopathy or other distant disease (fig. 2). A …

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A diagnosis of seclusion
P. Beckett, F. Chishti, D. Waller
Breathe Dec 2010, 7 (2) 189-191; DOI: 10.1183/20734735.006410

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A diagnosis of seclusion
P. Beckett, F. Chishti, D. Waller
Breathe Dec 2010, 7 (2) 189-191; DOI: 10.1183/20734735.006410
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