Case report A 76-yr-old nonsmoking female was referred for evaluation of complaints of subfebrile temperature and fatigue for 4 weeks. A few days before the visit she developed pain in the back of the left hemithorax and a tickling cough when breathing deeply. Two months earlier she had experienced a period of nonproductive cough, which resolved after medical treatment. There were no other pulmonary symptoms. Past medical history revealed venous thrombosis with pulmonary embolism after a curettage, rheumatoid arthritis and pneumonia.On physical examination she appeared healthy with a pulse of 80 beats . min -1 , blood pressure of 170/90 mmHg and a normal temperature. Apart from dullness over the basal part of the left hemithorax with normal breath sounds, physical examination was normal. Except for an erythrocyte sedimentation rate of 79 mm, laboratory tests were within normal limits.