The Case of the Man Who Lost a Lung But Won a Prize

Albert Lowenfels, MD

Disclosures

March 09, 2011

Introduction to the Case

The patient was a 56-year-old man who complained of severe cough and weakness of approximately 4 months duration. The onset of his illness began with fever, chills, and a mild cough. An x-ray taken at that time revealed an area of consolidation in the left lung, for which he was treated with a 1-week course of penicillin and bed rest. However, the patient's pulmonary symptoms persisted, and about 2 months after the onset of symptoms he had a tomogram of the lungs, followed by bronchoscopy and a biopsy. A week after the bronchoscopy an operation was performed. Because the patient did not want to be hospitalized, a team of surgeons and anesthesiologists performed the operation in the patient's home. The patient had a slow recovery, but 2 months after the operation he was well enough to attend his grandson's third birthday. Four and a half months after surgery he spent a day hunting with friends and relatives, but that night, to the family's surprise, he died quietly in his sleep.

Medical and Family History

Family and Personal History

The patient was a moderate drinker but smoked heavily, beginning as a teenager. His father, a heavy smoker, died of chronic obstructive pulmonary disease at age 71. His mother, who was also a heavy smoker, died at age 85 with a suspected lung tumor. His older brother, also a smoker, died at age 77 of cancer of the throat.

Medical History

He had appendectomy performed at age 19 and while in his 20s he developed a duodenal ulcer. During middle age, he developed claudication, which was sufficiently severe to necessitate a lumbar sympathectomy at age 54. The patient had a speech impediment that had persisted since childhood.

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