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[View large image] Clinical presentation:
A 28 year old woman with fever that she notices at night, and some weight loss.

There is a density lying behind the medial end of right clavicle and right first rib ( part of the 'Lawyer Zone' ). Its lateral margin extends to the upper margin of the clavicle, marking its location as neither truly anterior not posterior. Inferiorly the margin corresponds to the inferior border of the calcified costal cartilage of the right first rib. There is no contained air-bronchogram. There are additional small peripheral soft-tissue nodules projected in the right 1st and 2nd rib interspaces. Even accounting for the slight rotation to the left, the markings in the right lung appear increased. The ribs appear intact. The upper mediastinal boundaries are undisplaced, but there is a widening of the faint posterior mediastinal para-spinal shadow, behind the normal-size heart.

[Lymphoma]

[Differential]

cases that might resemble this pathology

[View large image] Carcinoma Bronchus (case report) 
[View large image] tuberculosis (case report)
[View large image] Mycetoma in Left Upper Lobe fibrosis (case report) 
[View large image] mediastinal haematoma (case report)

[View large image] neuroma (case report) 
[View large image] Metastasis although solitary apical involvement improbable. (case report)
[View large image] Massive pulmonary fibrosis silicosis (case report) [View large image] Pulmonary Infarct Improbable at apex (case report)

[View large image] (Histiocystosis X, case report) (but Solitary) eosinophil granuloma 
[View large image] Parasites, Fungal infection Hydatid cyst(case report)
[View large image] Azygous lobe (case report) 
[View large image] Overlying Structures (case report) include skin polyp
[View large image] Varicella Chicken-pox pneumonia (case report. One glance at the patient will exclude this one, but consider atypical infections complicating the original pathology). Nodular shadowing in Radiology Museum
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[London South Bank U.]

IDM May 2006