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Clinical Stem 1
Non-smoking female with a new right upper lobe lung mass and three PET-positive mediastinal lymph nodes

Case Description
A 65-year old white, non-smoking female required preoperative medical clearance before knee surgery. Past medical history included asthma since childhood. She complained of occasional dyspnea and wheezing. Physical examination was normal except for signs of left medial meniscus injury. She had minor memory loss but was independent in activities of daily living. She lived alone and had no children. Family history was unremarkable. A chest radiograph showed a 4 x 5 cm mass in the right upper lobe. Computed tomography confirmed the mass and also showed a 1.2 cm right lower paratracheal lymph node, a 1 cm left lower paratracheal node, and a 1.7 cm subcarinal node. Whole body PET-CT showed increased uptake in the primary tumor and in mediastinal lymph nodes stations 4R, 7 and 4L. Brain MRI was normal.