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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 56-Year-Old Woman With COPD and Multiple Pulmonary Nodules*

Ammar Sakkour, MD; Tisha Wang, MD; Donald Tashkin, MD
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Correspondence to: Tisha Wang MD, UCLA Pulmonary and Critical Care, Box 951690, 37-131 CHS, Los Angeles, CA 90095-1690; e-mail: tiwang@mednet.ucla.edu



Chest. 2008;133(2):566-569. doi:10.1378/chest.07-1613
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Extract

A 56-year-old woman with COPD was referred to the pulmonary clinic for the evaluation of multiple pulmonary nodules. One month prior, a routine chest radiograph (Fig 1 ) revealed a left upper lobe nodule. She denied cough, fevers, shortness of breath, weight loss, night sweats, or chest pain. She had a long history of dyspnea on exertion that was unchanged from her baseline values. Three years prior, COPD had been diagnosed based on the results of pulmonary function tests and a CT scan of the chest showing moderate-to-severe emphysema. No nodules were seen at that time. She had no other significant medical history, and was receiving only fluticasone, nasal budesonide (Rhinocort; AstraZeneca; Wilmington, DE), and hormone replacement therapy. The patient was a 30-pack-year tobacco smoker and had quit 8 years prior. She reported a 10-year history of heavy marijuana use and continued to smoke marijuana cigarettes daily. The findings of a recent Papanicolaou smear as well as a mammogram had been negative. She denied any occupational exposures, recent travel, or HIV risk factors. The findings of a review of her physiologic systems were negative for symptoms suggestive of collagen vascular disease.

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