Presentation of Case A 56-year-old man was admitted to the hospital because of hypoglycemia. There was a long history of alcohol abuse, with delirium tremens and hepatic disease. Eight years before admission a left pleural effusion developed, and a diagnosis of pulmonary tuberculosis was established. Chemotherapy was administered for two years, with questionable compliance. Four months before entry an x-ray film of the chest showed a nodule, 4 cm in diameter, in the right lung. An upper gastrointestinal study, an ultrasound study of the pancreas, and a liver-spleen scan were negative. The patient continued to imbibe large volumes of alcoholic.
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