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Chest Imaging and Pathology for Clinicians |

Ten Years of Chronic Cough in a 64-Year-Old Man With Multiple Pulmonary Nodules

Whittney A. Warren, DO; Scott S. Dalane, MD; Bryce D. Warren, PhD; Paul G. Peterson, MD; Rodney D. Boyum, MD; William Kelly, MD
Author and Funding Information

aDepartment of Pulmonary and Critical Care, Walter Reed National Military Medical Center, Bethesda, MD

bDepartment of Radiology, Walter Reed National Military Medical Center, Bethesda, MD

cDepartment of Pathology, Walter Reed National Military Medical Center, Bethesda, MD

dUniformed Services University of the Health Sciences, Bethesda, MD

CORRESPONDENCE TO: Whittney A. Warren, DO, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889


Copyright 2016, . All Rights Reserved.


Chest. 2016;150(3):e81-e85. doi:10.1016/j.chest.2016.03.040
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A 64-year-old male former smoker with a history of prostate cancer presented to our pulmonary clinic, complaining of nonproductive cough for 10 years. Prior evaluation included treatment for upper airway cough syndrome and gastroesophageal reflux, stopping angiotensin-converting enzyme inhibitor, and initiation of inhaled β-agonists. Esophageal pH monitoring indicated silent reflux, and proton pump inhibitor therapy was started. He continued to cough and complain of dyspnea. Physical examination produced unremarkable results, with no evidence of lymphadenopathy. Pulmonary function tests showed a pseudo-restrictive pattern with air trapping, hyperreactivity, and incomplete bronchodilator responsiveness: FEV1, 2.48 L (69% of predicted); FVC, 3.57 L (75% of predicted); FEV1/FVC, 92%; total lung capacity, 7.00 L (100% of predicted); and residual volume, 3.05 L (136% of predicted). Laboratory studies, including a complete metabolic panel, prostate-specific antigen test, and complete blood count, yielded normal results.

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