Lung Cancer

A 53-year-old man presented with a 3-day history of bilateral pain in the lower extremities. He also had a 3-month history of thickening and desquamation of skin, with associated itching, and a 5-lb (2.27-kg) weight loss. The skin changes initially appeared on the hands and subsequently became generalized.

A52-year-old white man presented with a pruritic eruption on the neck of 3 months’ duration. The rash had not responded to a potent topical corticosteroid prescribed by another practitioner for the presumed diagnosis of eczema. The patient reported no current health problems. His history included a pubic louse infestation and several episodes of uncomplicated urethral gonorrhea. He readily admitted to having unprotected sexual intercourse with prostitutes.

A 64-year-old man underwent a right pneumonectomy forsquamous cell carcinoma of the right lung. He was dischargedfrom the hospital on the fifth day after surgery.

A 64-year-old man underwent a right pneumonectomy forsquamous cell carcinoma of the right lung. He was dischargedfrom the hospital on the fifth day after surgery.

For the past 3 months, a 72-year-old man has had progressivelyworsening dyspnea on exertion and constantvague discomfort in the left chest that appears to have apleuritic component. He denies paroxysmal nocturnaldyspnea and has no history of chest trauma. However, hehas a chronic cough that sometimes produces purulentsputum-although it is not associated with hemoptysis.His feet swell occasionally, and he has mild anorexia andhas lost 20 lb in 6 months.

Smoking-related diseases have reached epidemic levelsamong women in the United States. Since 1980, neoplastic,cardiovascular, respiratory, and pediatric diseases attributableto smoking-as well as cigarette burns-havebeen responsible for the premature deaths of 3 millionAmerican women and girls. Lung cancer is now the leadingcause of cancer-related deaths among US women; itsurpassed breast cancer in 1987.1

Anisocoria and partial eyelid ptosis were detected during the routine eye examination of a 66-year-old woman. These findings had not been present during an examination 2 years earlier. Because the patient had no symptoms, she could not recall when these signs began. Her general health was unremarkable; she had smoked 1 pack of cigarettes per day for 40 years