Case Files 1: Breathing My Life Out

Q:A 29-year-old female of African descent presents to your hospital with symptoms of
cough, difficulty in breathing, lethargy, and felt some bumpy nodules on her neck. Physical exam shows cervical adenopathy and hepatomegaly. A chest X-Ray was done and the image was shown as below.

1. How should you further investigate for a confirmatory diagnosis?
a. Bronchoscopy and transbronchial lung biopsy
b. Serum angiotensin converting enzyme (ACE) level
c. Scalene node biopsy
d. Liver biopsy
e. Open lung biopsy

2. What would your diagnosis be?

Try and take your time to ponder, the solution is only if you can't find a satisfactory answer.

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