Case 43-1964

Presentation of Case First admission. A seventy-eight-year-old man entered the hospital because of hoarseness. Six years previously a biopsy of the larynx, which was performed because of hoarseness, revealed chronic inflammation. He was subsequently well until two months before admission, when hoarseness began to recur intermittently. He had had tuberculosis fifty years earlier and had smoked one package of cigarettes daily for many years. Physical examination revealed thickening of the vocal cords, with diminished mobility on the right side. X-ray films of the chest (Fig. 1) showed extensive fibrosis, collapse and bleb formation in the upper lobe of the left . . .