Young male smoker from a nursing home with ankylosing
spondylitis. He also had pulmonary Osteoarthropathy, making the consideration
of cancer lung strong. His sputum was repeatedly negative for TB and
cancer cells. This was before the days of fiberoptic bronchoscopy. You
not consider rigid bronchoscopy due to the stiff bent neck. Sequential
films show spontaneous regression of disease. Bilateral non-specific
upper lobe disease can be seen in this disease, and radiologically
cannot be distinguished between TB or when unilateral with cancer.