What's the Diagnosis? By Dr. Eric Chavis

A 27 yo M with a PMHx of osteosarcoma s/p R hip disarticulation and numerous lung metastases s/p L upper lobe wedge resection (1 year prior) presents to ED with DOE and "abnormal findings on outpatient CT scan." On ED arrival he is tachycardic w/ HR 135, RR is 18 and SpO2 is 93% on RA. On exam he has diminished but present breath sounds bilaterally. A CXR is obtained and shown below. What's the diagnosis? (scroll down for answer) 




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