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December 20, 1976

Hemoptysis With Cavitary Lung Lesion

Author Affiliations

From the Department of Medicine, Pulmonary Division, Yale University School of Medicine, New Haven, Conn.

JAMA. 1976;236(25):2889-2890. doi:10.1001/jama.1976.03270260045032

History  A 27-year-old woman was admitted to the hospital for hemoptysis of three days' duration. During the previous three years, she had experienced progressive dyspnea on exertion and intermittent left-sided pleuritic chest pain. A posteroanterior chest roentgenogram (Fig 1) was obtained, followed by lateral tomography of the left side of the chest (Fig 2).

Diagnosis  Cavitary sarcoidosis with pulmonary aspergilloma.

Comment  The chest roentgenogram (Fig 1) shows diffuse bilateral lesions. Small nodular lesions are present throughout the right lung and left base. There is a large cavity in the left upper lung zone with considerable overlying pleural thickening. The lateral tomogram (Fig 2) shows a rounded mass about 3 cm in diameter surrounded by a radiolucent zone, representing a mass in a cavity.Three years prior to this admission, sarcoidosis was diagnosed on the basis of bilateral hilar adenopathy, diffuse small nodular infiltrates on the chest roentgenogram, and a cervical