Volume 137, Issue 4, Pages (April 2010)

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Volume 137, Issue 4, Pages 983-988 (April 2010) Recurring Mouth Ulcer and Skin Rash in a Man With Abnormal Chest Radiograph Su-Ying Low, BMBCh, FCCP, Angela M. Takano, MD, Anantham Devanand, MBBS, Joanne Ngeow, MBBS, MRCP CHEST Volume 137, Issue 4, Pages 983-988 (April 2010) DOI: 10.1378/chest.09-1742 Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 1 CT scan of the thorax showing the centrilobular distribution of irregularly shaped cysts (long, thin arrow), cavitated nodules (short, thick arrow), and nodules (short, thin arrow) of varying sizes (A). CT scan of the thorax showing sparing of the lung bases and costophrenic angles with no evidence of lung fibrosis (B). CHEST 2010 137, 983-988DOI: (10.1378/chest.09-1742) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 2 CT scan image of the left mandible demonstrating an expansile lytic lesion underlying the first, second, and third molars, which hence appear like floating teeth. CHEST 2010 137, 983-988DOI: (10.1378/chest.09-1742) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 3 99mTc-methylene diphosphate whole-body scan showing increased uptake in the left mandible (short, thin arrow) as well as in the head and medial cortex of the proximal shaft of the left femur (short, thick arrow). CHEST 2010 137, 983-988DOI: (10.1378/chest.09-1742) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 4 Section of buccal mucosa with submucosal cellular infiltration composed of histiocytes, some with convoluted, grooved, or coffee bean-like nuclei, eosinophils, and lymphoplasmacytic cells (hematoxylin-eosin, original magnification ×60). CHEST 2010 137, 983-988DOI: (10.1378/chest.09-1742) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 5 CD1a immunohistochemical stain of BAL shows at least 5% of cells stained positively (magnification ×60). CHEST 2010 137, 983-988DOI: (10.1378/chest.09-1742) Copyright © 2010 The American College of Chest Physicians Terms and Conditions