Images in Clinical Medicine

Radiographic Evidence Linking Tobacco Use and Lung Cancer

David Michael McMullan, M.D., and Gordon Alan Cohen, M.D., Ph.D.

N Engl J Med 2006; 354:397January 26, 2006

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Article

A 72-year-old man presented for evaluation of progressive dyspnea and cough. He reported smoking one to two packs of cigarettes a day since the age of 15 years. Standard chest radiography showed a suspicious lesion in the right thoracic cavity. Computed tomography of his chest revealed bullous emphysema (thick arrow), a tumor involving the middle lobe of the right lung (thin arrow), and a pack of cigarettes in his shirt pocket (asterisk). Biopsy of the lesion confirmed the presence of non–small-cell lung cancer.

David Michael McMullan, M.D.
Gordon Alan Cohen, M.D., Ph.D.
University of Washington, Seattle, WA 98195