case 5 Routine Screening Radiograph in a 60-Year-Old Smoker

Routine Screening Radiograph in a 60-Year-Old Smoker
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BACKGROUND
A 60-year-old man presents to the emergency department after
accidentally falling when he tripped over a sidewalk curb. On the
review of systems, the patient reports occasionally having a dry
cough. He states that he has had the cough "for quite some time" and
attributes it to his 40-pack-year history of smoking cigarettes. On
further questioning, he denies having weight loss, hemoptysis, or
shortness of breath.

On physical examination, the patient is a man of moderate build, in
no apparent distress. His blood pressure, heart rate, and respiratory
rate are within normal limits. He has normal breath sounds and no
respiratory distress. Findings on chest, abdominal, and the rest of
his physical examination are unremarkable. A chest radiograph is
obtained. When the results are reviewed, a CBC and chemistry panel
are ordered and deemed noncontributory. Contrast-enhanced chest CT
scanning is performed.

What is the diagnosis?
Hint
The diagnosis is the most common benign tumor of the lung.
Author: Gautam Dehadrai, MD, Staff Radiologist, Department of
Radiology, Veterans Affairs Medical Center, Albuquerque, NM
eMedicine Editor: Rick G. Kulkarni, MD, Assistant Professor, Yale
School of Medicine, Section of Emergency Medicine, Department of
Surgery, Attending Physician, Medical Director, Department of
Emergency Services, Yale-New Haven Hospital, Conn

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