A 53-year-old African American woman was admitted to our hospital for intractable nausea and vomiting that she’d been experiencing for a month. She also reported dysphagia with solids and occasionally with liquids. She had no chest or abdominal pain, and no fever, bleeding, diarrhea, significant weight loss, or significant travel history. The patient was not taking any medication and her physical exam was normal. The patient’s complete blood count and electrolytes were normal. We ordered a chest x-ray (FIGURE 1).
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