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Postgraduate Education Corner: Chest Imaging and Pathology for Clinicians |

A 50-Year-Old Man With a Cough and Painful Chest Wall MassCough and Painful Chest Wall Mass

Quentin Jones, MBBS; Rachel Benamore, MBBChir; Eve Fryer, BMBCh; Anny Sykes, PhD
Author and Funding Information

From the Oxford Centre for Respiratory Medicine (Drs Jones and Sykes) and the Department of Radiology (Dr Benamore), Churchill Hospital; and the Department of Histopathology (Dr Fryer), John Radcliffe Hospital, Oxford, England.

Correspondence to: Quentin Jones, MBBS, Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, OXE 7L3, England; e-mail: quentinjones7@hotmail.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(5):1158-1161. doi:10.1378/chest.13-2039
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Extract

A 50-year-old man presented with a 1-week history of a painful hard lump above his right nipple. He attended the Accident and Emergency Department when the lump suddenly grew bigger and more painful. He had been unwell for 4 weeks, with a productive cough, loss of appetite, and weight loss. He was normally well, and there was no relevant medical history. He smoked 50 cigarettes a day and drank excessive quantities of alcohol each week. He worked in a warehouse and had not traveled outside the United Kingdom. On examination, he was comfortable at rest and did not look unwell. He was apyrexial, and oxygen saturations were 98% on room air. His BP was 110/70 mm Hg, and pulse rate was 90 beats/min. There was a large, hard, tender mass above his right nipple associated with some bruising of the skin. On auscultation of his chest, a few crackles were audible. His dentition was poor. The remainder of his physical examination was normal.

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