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March 23, 1970

Long-Standing Pneumonitis

Author Affiliations

From the weekly X-ray Seminar, Department of Radiology, Massachusetts General Hospital, Boston.

JAMA. 1970;211(12):2004-2005. doi:10.1001/jama.1970.03170120050009

Dr. Sidney P. Kadish: The patient, a 15-year-old white boy, was admitted to the Massachusetts General Hospital for increasing dyspnea of six months' duration. The patient had been in good health before the onset of the illness. Over this six-month period, he had a dry, hacking, nonproductive cough, gradual onset of dyspnea on exertion, and a weight loss of 4.1 kg (9 lb). The patient was referred here after admission to a community hospital where antibiotics gave no symptomatic relief and a biopsy specimen of the cervical lymph node was normal.

At the time of physical examination, the patient was noted to be afebrile, and dry rales were heard in both lungs. Enlarged lymph nodes were felt in the anterior portion of the neck bilaterally and in the supraclavicular area on the left side. One examiner thought he felt a slightly enlarged spleen. The remainder of the physical examination was