Before Turning the Page: Interpret the Chest Radiograph and Ct Scan, Suggest a Diagnosis and Propose Useful Complemen-

A 56 yr old nonsmoking woman was admitted to hospital in 1985 with left sided chest pain and weight loss. She had a history of pulmonary tuberculosis 35 yrs previously. An extrapleural therapeutic pneumothorax had been performed at that time and was complicated several years later by chronic pyothorax. On admission in 1985, she had no dyspnoea or cough. Physical examination showed decreased breath sounds in the upper left chest. No superficial lymphadenopathy was found. A peripheral white cell count revealed 10.5×109·L-1 leucocytes, of which 9.15×109·L-1 were polymorphonuclear cells and 0.6×109·L-1 were lymphocytes. The erythrocyte sedimentation rate was 60 mm in the first hour. A chest radiograph (fig. 1) and computed tomographic (CT) scan (fig. 2) are shown. CASE FOR DIAGNOSIS