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2014-December: A Patient with Dyspnea & Haemoptysis

posted Dec 27, 2014, 1:18 AM by OEM CU   [ updated Jan 2, 2015, 8:02 AM ]
31 years old male heavy smoker patient living in Embaba (though used to live in Helwan (Maasara) for 24 years) and working as a driver (worked in marble cutting for 2 years prior to the current job) presented to the clinic. The patient claimed that, two month ago, he started to complain of progressive exertional dyspnea, cough and expectoration of yellowish (sometimes blood tinged) sputum which increase at night and on lying down. There was, also, history of progressive right side chest pain and weight loss during the last 2 months but there was no history of fever. Chest examination showed dullness and diminished air entry on the Rt side of the chest. 
TLC was 7.5X109/LESR (first hour) was 120, tuberclin test was negative and sputum analysis for acid fast bacilli for 3 successive days was also negative. Chest X-Ray and CT chest (see bellow) were done.
What are the positive radiologic findings? 
Are there any further investigations required? What are they? and
Based on the provided clinical laboratory and radiologic findings, What is the most probable Diagnosis? 
 







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