E. J. Mark

Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 46-1967.

Presentation of Case A forty-five-year-old man was admitted to the hospital because of episodic severe dyspnea. He had been well until six months previously, when a cough and low-grade fever developed. Demethylchlortetracycline (Declomycin) was administered. An x-ray film of the chest showed a hazy density in the right-lower-lung field extending from the eighth rib posteriorly to the diaphragm, appearing most dense in its peripheral portion. On admission to another hospital 25 ml of thin, amber fluid was aspirated from the right pleural space; routine cultures and cultures for tubercle bacilli were negative. On the fifteenth hospital day a portion of .xa0.xa0.

A 43-year-old woman with left-buttock pain and a presacral mass.

Presentation of Case A 43-year-old woman was admitted to the hospital because of low-back pain and a presacral mass. The patient was well until seven months earlier, when increasing pain developed in the left buttock; the pain was aggravated during her menses and by sitting and was improved on recumbency. A computed tomographic (CT) scan of the abdomen and pelvis, performed elsewhere, was reported to show a mass behind the uterus, just to the left of the midline, with extension around the rectum. An intravenous urographic examination was reported to show a pelvic mass with localized narrowing of the left .xa0.xa0.

Schistosomiasis of the urinary bladder (infection with S. haematobium).

Presentation of Case A 32-year-old man was evaluated for a lesion of the urinary bladder. The patient had been well until 16 months earlier, when he had an episode of perineal pain associated with painful ejaculation and a brown, curdled ejaculate. There was no hematuria. His condition improved after treatment with ciprofloxacin. He had had no previous genitourinary symptoms except for the long-standing presence of dribbling after voiding. Four months before the evaluation, the patient was seen at this hospital because of urinary frequency of four days duration, with intermittent passage of small blood clots in the urine, vague discomfort .xa0.xa0.

A 69-year-old man with exposure to talc and a pulmonary mass

Presentation of Case A 69-year-old man was admitted to the hospital because of the radiologic finding of pulmonary nodules. The patient had been well until several weeks earlier, when a cough, fever, and dyspnea developed. A thoracic radiograph obtained at another hospital 11 days before admission (Figure 1) showed an irregular nodule, 2 by 1.5 cm, in the right upper lobe and additional bilateral nodules. There was no hilar or mediastinal lymphadenopathy. A thoracic computed tomographic (CT) scan (Figure 2A and Figure 2B) revealed a spiculated mass in the periphery of the right upper lobe and multiple smaller nodules, 2 to 5 .xa0.xa0.

Case 21-1999

Presentation of Case A 69-year-old man was admitted to the hospital because of the radiologic finding of pulmonary nodules. The patient had been well until several weeks earlier, when a cough, fever, and dyspnea developed. A thoracic radiograph obtained at another hospital 11 days before admission (Figure 1) showed an irregular nodule, 2 by 1.5 cm, in the right upper lobe and additional bilateral nodules. There was no hilar or mediastinal lymphadenopathy. A thoracic computed tomographic (CT) scan (Figure 2A and Figure 2B) revealed a spiculated mass in the periphery of the right upper lobe and multiple smaller nodules, 2 to 5 .xa0.xa0.

Case 43-1991: A 27-Year-Old Man with AIDS, a Cough, Fever, and Pulmonary Infiltrates

Presentation of Case A 27-year-old man with the acquired immunodeficiency syndrome (AIDS) was admitted to the hospital because of a cough, fever, and an abnormal radiograph of the chest. The patient was well until 8 1/2 months earlier, when he was first admitted to this hospital because of a headache, fever, cough, and dyspnea for two days. He had emigrated from Puerto Rico two months earlier, after his wife and child died of AIDS; his wife had received transfusions in the past after a gynecologic operation. The patient had lost 9 kg in weight during the previous two or three .xa0.xa0.