Lung tumors (primary and metastatic)Downloads

A 61-year-old man presents to the urgent care clinic complaining of cough and unintentional weight loss over the past 3 months. He works as a computer engineer, and he informs you that he has been having to meet several deadlines recently and has been under significant stress. His medical history is significant for gout, hypertension, hypercholesterolemia, diabetes mellitus type 2, and pulmonary histoplasmosis 10 years ago. He currently smokes 2 packs of cigarettes/day, drinks a 6-pack of beer/day, and he endorses a past history of cocaine use back in the early 2000s but currently denies any drug use. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 87/min, and respiratory rate 18/min. His physical examination shows minimal bibasilar rales, but otherwise clear lungs on auscultation, grade 2/6 holosystolic murmur, and a benign abdominal physical examination. However, on routine lab testing, you notice that his sodium is 127 mEq/L. His chest X-ray is shown in the picture. Which of the following is the most likely underlying diagnosis?

A 61-year-old man comes to the physician because of a 2-month history of a cough productive of clear mucoid sputum. He has smoked one pack of cigarettes daily for 33 years. Physical examination shows no abnormalities. Chest x-ray shows a 2-cm solid nodule in the periphery of the lower left lobe. A bronchial biopsy of the mass shows numerous mucin-filled epithelial cells lining the alveolar basement membrane. The cells have prominent nucleoli, coarse chromatin, and some cells have multiple nuclei. Which of the following is the most likely diagnosis?