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An 82-year-old man was admitted to hospital because of asthenia, anorexia, and cough with blood-tinged sputum for the preceding 2 weeks. He had smoked one pack of cigarettes per day for 40 years but had stopped 20 years earlier. Two years before presentation a coronary angiography and echocardiography were performed for evaluation of chest pain, which revealed normal coronary arteries and normal left ventricular function. He had a history of hypertension and permanent atrial fibrillation but had been otherwise well, and there was no history of heart failure. The complete blood count, and serum values of glucose, creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, sodium, potassium, calcium, and phosphorus were normal. A chest radiograph showed a mass in the left upper lung field. A CT scan of …
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