Correct!
5. All of the above
The constellation of findings thus far indicate that paraneoplastic pemphigus is responsible for the oral and genital ulcerations and is associated with surgically proven, and now presumably recurrent, hyaline vascular Castleman disease. The concurrence of these entities may be associated with other conditions, notably obstructive pulmonary disease. Therefore, pulmonary function testing and chest imaging are appropriate. Surgical consultation for removal of the recurrent pelvic mass is appropriate, and the tissue sampling and autoantibody testing results, in the context of pathologically proven Castleman disease, raise the possibility of paraneoplastic autoimmune multiorgan syndrome (PAMS), suggesting the oncological consultation would be of benefit also.
The patient underwent high-resolution chest CT (Figures 6 and 7).
Figure 6. Left (A-I): Axial unenhanced inspiratory HRCT images through the upper (A-C), mid (D-F) and lower (G-I) lungs. Right: Video of axial unenhanced inspiratory HRCT.
Figure 7. Left (A-I): Axial unenhanced post-expiratory HRCT images through the upper (A-C), mid (D-F) and lower (G-I) lungs. Right: video of unenhanced post-expiratory HRCT.
Which of the following represents an appropriate interpretationfor this examination? (click on the correct answer to be directed to the ninth of twelve pages)