Case 168

 A sixty four-year-old male presented in our hospital for disorder of taste sensation and loss of appetite for a few months. Further, severe cough and yellow sputum were followed from last month. He swallowed a tab of zinc supplement for a while in order to improve taste sensation. He smoked 20 cigarettes per day for 50 years. He drank sake 180mL/day. Laryngoscope showed no evidence of pharyngitis and laryngitis. Laboratory test revealed: white blood cells 5800 (eosinophils 7.5%, monocytes 12.0%), CRP 5.97 mg/dL, Zn 83 µg/dL (>80), Hb 13.8 g/dL. LDH 273 U/L (124-222), CA19-9 39 U/mL (<37), IL-2 790 U/mL (157-474).
 He took CT for further investigation.

What is your diagnosis on chest CT ?

1.　Malignant lymphoma

2.　Sarcoidosis

3.　Metastatic lung tumor

4.　Pulmonary Tbc

5.　Pulmonary fungus

answer

2019.11.6