Case 34-1983

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Abstract
Presentation of CaseA 32-year-old man was admitted to the hospital because of a question of metastatic testicular cancer.He was well until four months earlier, when he noticed slight pain and swelling of the left testis, accompanied by a nonproductive cough and exertional dyspnea. Three months before admission an x-ray film of the chest (Fig. 1), obtained elsewhere, revealed a diffuse fibronodular pattern in both lungs. Pulmonary-function studies showed mild to moderate restrictive and obstructive defects. A diagnosis of interstitial lung disease was made. One month later there was an increase in long-standing low-back pain.One month before admission . . .