Right Upper Lobe Mass in a Shepherd

History A 44-year-old Basque man (13-year resident of southern California) was hospitalized because of a ten-day episode of cough, right-sided chest pain, and mild hemoptysis. He had been a shepherd in Spain as well as in southern California. His immigration chest x-ray film in 1965 was reported as "normal," and his history was otherwise noncontributory. An intermediate-strength (5-TU biological equivalent) skin test was nonreactive; a Casoni skin test reaction was negative; a complete blood cell count, including levels of eosinophils, was normal. Bilirubin and liver enzymes levels were normal. The liver-spleen scan did not demonstrate focal defects. Posteroanterior and lateral roentgenograms of the chest at the time of admission are shown in Fig 1 and 2. Section Coordinators: Thomas C. Beneventano, MD (Case of the Month); Juan A. del Regato, MD (Therapeutic Radiology); Jack Edeiken, MD (Diagnostic Radiology); Barry B. Goldberg, MD (Ultrasonography); E. Robert Heitzman, MD (Diagnostic Radiology); Stanley