Recent onset of cough and severe shortness of breath. A chest X-ray in an outlying hospital showed a nodular pulmonary pattern.
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Chest X-ray performed after administration of contrast for CT - hence the incidental IVP - not relevant. Note old healed left clavicle fracture. The lungs show diffuse thickening of the interstitium, peribronchial cuffing, with prominent Kerley A lines and Kerley B lines. No definitive mass is demonstrated but the hila are prominent suggesting possible lymphadenopathy.
This patient was shown to have chronic myeloid leukemia with pulmonary leukemic infiltrates.