Mystery Quiz

February 4, 2011

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The patient is an 84 year old man who presents with small amounts of hemoptysis for one week prior to admission. He is a life-long non-smoker who began having cough with sputum production for one year without fever, chills, nightsweats, orthopnea, weight loss, arthralgias or rash. The patient denied unusual occupational exposures, history of prior TB, travel, or owning pets. The past medical history was significant for coronary bypass surgery, hypertension, atrial fibrillation treated with aspirin, and diabetes mellitus. A recent echocardiogram was unremarkable.

Chest film and chest CT are shown below:


The most likely diagnosis is:

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3 Responses to Mystery Quiz

  1. mike c. on January 28, 2011 at 2:52 pm

    So what is diagnosis? I think adenocarciona is unlikely one since the patient denies weight loss and there is no nodule image shown…

  2. Paul on February 1, 2011 at 6:30 pm

    Soooo hen do we know the answer. IMO it’s Pulmonary aspergilosis, b/c of the diabetic condition of the patient… any more answers?

  3. Mystery Quiz- The Answer | Clinical Correlations on February 11, 2011 at 2:33 pm

    [...] answer to the mystery quiz is pulmonary artery aneurysm. The chest CT shows a very round lesion in the left lower lobe with [...]

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