0
Postgraduate Education Corner: CASE RECORDS OF THE UNIVERSITY OF COLORADO |

A 45-Year-Old Man With a History of Hepatitis C and Testicular Cancer Presents With Cavitary Lung Lesions and Palpable Purpura

Timothy J. Bedient, MD; Marvin I. Schwarz, MD, FCCP; Steve D. Groshong, MD, PhD; Edward D. Chan, MD
Author and Funding Information

Affiliations: From the Divisions of Pulmonary Sciences and Critical Care Medicine (Drs. Bedient, Chan, and Schwarz), University of Colorado Denver, Denver, CO; Denver Veterans Administration Medical Center (Drs. Chan and Schwarz), Denver, CO; and the Department of Pathology (Dr. Groshong) and Division of Pulmonary Medicine (Dr. Chan), National Jewish Health, Denver, CO.

Correspondence to: Timothy J. Bedient, MD, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Anschutz Medical Campus, Research 2, Box C272, Ninth Floor, 12700 East Nineteenth Ave, Aurora, CO 80045; e-mail: timothy.bedient@ucdenver.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(4):1168-1174. doi:10.1378/chest.09-0627
Text Size: A A A
Published online

Extract

A 45-year-old man presented with progressive dyspnea for 2 weeks, left pleuritic chest pain for 1 week, and a bilateral ankle rash for the past 10 days. He had hepatitis C, for which he had received no treatment, and a history of polysubstance abuse, but he had not consumed alcohol for 7 years or IV drugs for 20 years. He was a current cigarette smoker (15 pack-year history of smoking). Eighteen months ago, he was found to have stage 4 embryonal left testicular cancer, metastatic to the lungs, and the retroperitoneal, axillary, and inguinal lymph nodes. He underwent a left orchiectomy and received six cycles of chemotherapy with bleomycin, etoposide, and cisplatin. His serum α-fetoprotein level was 77 μg/L and fell to 5 μg/L after chemotherapy. A repeat chest CT scan showed nearly complete resolution of pulmonary metastases with multiple, small, subcentimeter nodules bilaterally, and one nodule in the left upper lobe measuring 1.2 × 0.9 cm. There had been no follow-up for the preceding 12 months.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543