Case 2-1990

Presentation of Case A 63-year-old woman was admitted to the hospital because of chronic bilateral maxillary sinusitis and hilar and mediastinal lymphadenopathy. The patient was in a stable state of health until five months earlier, when x-ray films of the paranasal sinuses, obtained in evaluation of bilateral iritis, showed complete opacification of both maxillary sinuses (Fig. 1), compatible with marked membrane thickening; the ethmoid, frontal, and sphenoid sinuses appeared normal, and no bony abnormalities were seen. Two months before entry an x-ray film of the chest revealed that the heart was at the upper limit of normal in size, and . . .