Chest
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A 51-year-old woman with no comorbidities presented with a 3-month history of cough with mucopurulent expectoration and intermittent fever. Over the past 1 month, she complained of streaky hemoptysis and gave history of expectorating "whitish pellets" in the sputum on two occasions. ⋯ She was a nonsmoker and did not consume alcohol. She had received multiple courses of antibiotics at another center with no relief of symptoms.
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The occurrence of catamenial pneumothorax (CP) is rare, and the awareness of this diagnosis among physicians is insufficient. CP is highly correlated with pelvic endometriosis and remains the most common form of thoracic endometriosis syndrome. Circulating endometrial cells (CECs) have been previously detected in patients with pelvic endometriosis. Could CECs bring new insights into pneumothorax management? ⋯ This proof-of-concept study demonstrates successful isolation and characterization of CECs in patients with SP. Identification of CECs in SP could alert endometriosis involvement and help early referral to gynecologic consultation for further examination and treatment.
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A 49-year-old man was sent by his primary care physician to the rheumatology clinic with complaints of several months of bilateral lower extremity swelling. The swelling migrated from both ankles up to his knees. Presenting symptoms consisted of bilateral knee pain as well as bilateral wrist and hand pain with swelling. ⋯ The examination was notable for bilateral knee effusions. Radiographs of his wrists, hands, and knee were obtained, along with a chest radiograph. He was then referred to a pulmonologist for further workup.