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A 42-year-old man presented with productive cough, haemoptysis, night sweating, temperature 39°C, asthenia and weight loss of 35 kg in 12 months. He had a 25-year history of smoking (40 cigarettes/day) and alcoholism. Laboratory tests showed normochromic normocytic anaemia (haemoglobin 8.8 g/dL, red blood cell 2.72×106/mmc, and mean corpuscular volume 100), neutrophilic leucocytosis and white cell count 17 78×103/mmc). Chest CT scan revealed an excavated lesion in the apico-dorsal segment of the left upper lobe (65×70 mm) with solid vegetation inside, delimitated by a thick wall with polylobate edges, and the suggestive presence of …
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