Mystery Radiology Challenge

62 year old male smoker with past medical history notable for hypertension, copd, comes to clinic complaining of chronic cough x 6 months with minimal sputum, no wheezing.  Lung exam shows decreased breath sounds throughout.  Pt had the following CXR performed:

x-ray 3r       x-ray 3ra

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What’s your diagnosis and the next step in his evaluation?  Please submit your answers by clicking on the “comments” link below this post.  For those of you who are unwilling to attach your name, you can post your comments anonymously.  Responses will be posted for 1 week when the answer will be revealed…

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