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Previous Volume 359:1603-1614 October 9, 2008 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 39-year-old man was admitted to this hospital because of chest pain, arthralgias, and a mediastinal mass.

Two months before admission, pain in the middle and right chest developed, which radiated intermittently to the right arm, increased in intensity with deep inspiration or changes in position, and was accompanied by fatigue and mild shortness of breath; there was no wheezing, cough, or production of sputum. He came to the emergency department of this hospital.

He had been admitted to this hospital approximately 1 year earlier because of similar symptoms associated with diffuse arthralgias; an electrocardiogram at that time showed a . . . [Full Text of this Article]

Differential Diagnosis

Mediastinal Mass

Tumors

Infection

Systemic Inflammatory Diseases

Arthritis

Optic Neuritis

Other Extrathoracic Organ System Disease

Glucocorticoid Use

Positive Test for Anca

Summary

Clinical Diagnosis

Dr. Peter A. Merkel's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Arthritis Center, Boston Medical Center, and the Department of Medicine, Boston University School of Medicine (P.A.M.); the Cardiology Division (D.M.) and the Departments of Radiology (A.S.) and Pathology (J.R.S.), Massachusetts General Hospital; and the Departments of Medicine (D.M.), Radiology (A.S.), and Pathology (J.R.S.), Harvard Medical School — all in Boston.

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