Laboratory analyses revealed the following: WBC count, 2,600 cells/μL; hematocrit, 31%; platelet concentration, 89,000 cells/μL; sodium concentration, 133 mEq/L; potassium concentration, 3.9 mEq/L; chloride concentration, 103 mEq/L; bicarbonate concentration, 21 mEq/L; BUN concentration, 21 mg/dL; creatinine concentration, 1.3 mg/dL; and glucose concentration, 116 mg/dL. Arterial blood gas analysis revealed the following: pH, 7.44; Pco2, 25 mm Hg; and Po2, 70 mm Hg. Serology results for antineutrophil cytoplasmic antibodies, antinuclear antibodies, and rheumatoid factor were negative. A repeat chest roentgenogram revealed new nodules, and growth of the old nodules (Fig 1, right, b). A CT scan of the chest confirmed new nodular infiltrates in all lung fields, growth of the nodules, and growth of the mediastinal lymph nodes (Fig 2, bottom, b). A surface ECG demonstrated a normal sinus rhythm with no ST-wave or T-wave abnormalities. A transthoracic echocardiogram demonstrated normal left and right ventricular function, no valvular abnormalities, and normal pulmonary pressures. Blood and sputum cultures were negative.