Imaging Case of The Week 10

You have just seen a 45 year old male with a predominant history of left upper chest pain and shoulder pain which has been keeping him awake at nights for many weeks.

On further questioning, he admits to having dyspnoea. He is a chronic smoker with a 20 pack year smoking history. You decide to get a chest x-ray and the x-ray is here. What is your diagnosis?

Answer
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