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Chest. 2019 Jun;155(6):e175-e178. doi: 10.1016/j.chest.2019.01.017.

A 52-Year-Old Woman With an Abdominal Mass, Bilateral Pulmonary Nodules, and Mediastinal and Hilar Lymphadenopathy.

Author information

1
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN.
2
Department of Pathology, Methodist Dallas Medical Center, Dallas, TX.
3
Pulmonary Medicine Consultants, Richardson, TX.
4
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
5
Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ.
6
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN. Electronic address: yi.joanne@mayo.edu.

Abstract

A 52-year-old, nonsmoking, African-American woman with a history of obesity, hypertension, and rheumatoid arthritis was referred for workup of multiple bilateral pulmonary nodules. The pulmonary nodules were discovered incidentally while undergoing a CT scan for an abdominal mass that was radiographically diagnosed as a uterine leiomyoma. She was asymptomatic from a pulmonary standpoint without unintentional weight loss, fevers, or night sweats. Her mother and sister had a history of lung cancer. She was diagnosed with rheumatoid arthritis 5 years earlier that was controlled with adalimumab for approximately 3 years when she stopped being seen by her rheumatologist and discontinued adalimumab. During evaluation for the abdominal mass, she re-established care with a rheumatologist and was started on 40 mg prednisone daily with plans to restart adalimumab once the workup for the abdominal mass and pulmonary nodules was completed. She had undergone bariatric surgery with cholecystectomy approximately 5 years earlier, after which she experienced intentional postsurgical weight loss.

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