Dr. Pepe’s Diploma Casebook: Case 83 – SOLVED!


Dear Friends,

Today I am showing chest radiographs of a 59-year-old man with abdominal pain and pruritus.
What do you see?

Check the images below, give me your thoughts in the comments section, and come back for the answer on Friday.



Click here for the answer

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    13 Responses to : Dr. Pepe’s Diploma Casebook: Case 83 – SOLVED!

    1. aloria says:

      Diffuse bony sclerosis

    2. Diogo Pinheiro says:


    3. murzin says:

      With the hint from aloria I think mastocytosis.

    4. sht says:

      i too take hint from above! – mastocytosis
      flattened right dome.
      anterior (and posterior?) cardiophrenic angle blunted.

    5. Stevan says:

      Others gave a hint, so I remembered that there was a case of mastocytosis earlier. After a brief search, it found that indeed it was in Caceres Corner case 103, and radiographs belong to the same patient.

    6. Dr Pepe says:

      I imagine the case is either too easy or too difficult, because there are only four brave doctors answering.

    7. genchi bari italia says:

      …carissimo Professore …..oppure il caso lo hai già presentato un’altra volta….non ricordi?????

      • Dr. Pepe says:

        You are right: case 103 of Caceres’ corner. Considering my advanced age, it is a miracle that after presenting over 200 cases, I have repeated only one!
        Still, this case is an excuse to discuss the thoracic spine in the chest radiograph, to be seen on Friday.

        • genchi bari italia says:

          …grandissimo Prof: ….l’avevo capito e per questo motivo non ho partecipato alla discussione…..il mio Bari è 2° in classifica e vede profumo di serie A !!!!

    8. hossam says:

      hello everybody.
      good job.
      how can i follow the daily / weekly posts by Dr Pepe??
      how can i regularly participate in this quiz??


      • ESR Office says:

        Just bookmark this page.
        Dr. Pepe’s cases are posted on a Monday, usually every two weeks (with occasional exceptions). You can also follow the ESR on Facebook, as new cases are posted on our page: facebook.com/myESR