A 29-Year Old Man With an Enlarging Lung Lesion With Calcifications Giving Finger-in-Glove Appearance

A 29-year-old man with a medical history of chronic rhinosinusitis presented with a 6-month history of chronic nonproductive cough and mild exertional dyspnea. Five years ago, at the time of his chronic rhinosinusitis diagnosis, he underwent a chest radiograph that revealed an ill-defined opacity in the middle zone of the left lung, suspicious for neoplasm, and was subsequently lost to follow-up, until he presented now with cough and dyspnea. There was no history of hemoptysis, epigastric discomfort/burning sensation, dysphagia, or post-tussive vomiting associated with cough. Exertional dyspnea was graded as modified Medical Research Council grade 1, and it was not associated with any diurnal or postural variations (orthopnea/trepopnea), chest pain, palpitations, or pedal edema. There was no history of fever, malaise, weight loss, or audible wheeze. The patient had no significant medical history of asthma, COPD, nasal obstruction, urticaria, or other chronic respiratory conditions. He did not smoke and reported no significant occupational or environmental exposures to allergens. There was no history of TB contact or recurrent respiratory infections. Additionally, there was no family history of similar respiratory findings or conditions. During the intervening years, the patient remained asymptomatic until his presentation with the new concerns.