The insidious onset of dyspnea and right lung collapse in a 35-year-old man.

A 35-year-old man presented with 4-month history of cough, chest pain, and shortness of breath. There was no history of fever, hemoptysis, night sweats, weight loss, environmental/drug exposure, or foreign travel. He was a nonsmoker with no previous medical illness. Chest radiographic findings were reported as normal. He was treated with two courses of antibiotics and a cough suppressant. Over the next 2 months, his cough persisted and his weight decreased by 2 kg. A repeat chest radiograph showed partial collapse of right lower lobe. He was unable to produce sputum, and was started on empiric quadruple antituberculosis therapy. Just over 1 month later, central chest pain with worsening dyspnea developed. The chest radiograph now showed a complete collapse of the right lung. He was referred for further evaluation and management.