It is every man's obligation to put back into the world at least the equivalent of what he takes out of it.

 O' God give me some light

In my dark days send an angel who can give me a little light

Life is like a rose 

I dare to hold close

O' God you gave me a life

I pray give me the gift of living well

Born alone, live alone, die alone

Life is like a rose.

 Many people dare to hold it close

 To their heart but only a few feel that pain is inflicted by the thorn .

‘Money’ and ‘Power’ are the root causes in every act of felony, every crime, every treachery committed since time immemorial. 

Money, gold, holds allure because it gives power, a lavish lifestyle and many are ready to harm a life for its powerful charisma.

 Money tempts most people to wrongdoing. 

Crime is as old as humanity.

 Thus, it is since ancient times that brothers are slaughtering brothers for the power of the throne and the wealth it brings along. 

Slaughtering, poisoning, strangling, asphyxiating, backstabbing, but achieving money and power and destroying every life on the way. 

Such is the queer nature of the human race.

Breathing is a race, 

With longing and restlessness everywhere

Bearing grief every day 

All my life in a certain way 

To see if you feel alive

Or just existing muddled

 A son instead of being dutiful towards his parents desires the end of the ailing, helpless parents and shoves them out of the way, 

A raving egomaniac parent drunk with the influence of wealth, affluence, power withholds what the ailing sibling truly deserves, thus strangling life out bit by bit

All mankind is from Adam and Eve, an Arab has no superiority over a non-Arab nor a non-Arab has any superiority over an Arab; also a white has no superiority over black nor a black has any superiority over white except by piety and good action. Learn that every Muslim is a brother to every Muslim and that the Muslims constitute one brotherhood. Nothing shall be legitimate to a Muslim which belongs to a fellow Muslim unless it was given freely and willingly. Do not, therefore, do injustice to yourselves. 

If the renowned Prophet Muhammad 

Equality he could understand 

Being all equal and independent, no one ought to harm another in his life, health, liberty, or possessions.

 Then why did it happen to me?

Is there any ethnic or national pride?

Unless you achieve or attain and 

Care for the dazed or dead!

Made me Rid all of spurious notions of goodness 

And badness from a wedded elephant 

Deserves to be under the spotlight than it has received. 

It is truly a satirical glory propped full with a spouse's cunning, humour and genius.

 It is a detective spoof that far outdistances the fabled tales of the great Sherlock Holmes and may well have been the Inspiration for Elephant's sister's was stolen mumbo jumbo. 

Mum demonstrates her canny ability to make the unbelievable, logical and the bizarre and absurd practical

Really and reasonable.

 I highly recommend this book for everyone as its reading adds a unique spice to one’s life.

Because Mum happens to be a good culinarian 

The best thing for sadness is to learn something.

 That is the only thing that never ceases to function.

Stepping into enemy territory with courage to defeat the giant

 That is holding your dream captive

With fierce coward's assault by mate

So overweight 

Yet a celebrity attractive

It is every man's obligation to put back into the world at least the equivalent of what he takes out of it.

 You may grow old and trembling in anatomies, 

You may lie awake at night listening to the disorder of your veins,

 You may miss your only love of Mum

 You may see the world about you devastated by evil lunatics, 

Or know your honour trampled in the sewers of baser minds. 

There is only one thing for it then — to learn. 

Learn why the world sways and what wags it. That is the only thing which the mind can never exhaust, never alienate, never be tortured by, never ,fear or distrust, and never dream of regretting

Life consists not in having good cards

But playing those you hold well.

Jealousy doesn't open doors it closes them

A dazzling smile, help and honour seasons will change

Somatostatin-analogues, even if inactive in inhibiting proliferation, could still play a role in meningioma therapy, contrasting secretory phenomena associated

 There is no cure available for neuroendocrine tumors available yet but as usual, there is treatment. The prognosis of the patient can be decided on the basis of stage and grade of cancer and certain other factors like age, the general condition of the patient. All these factors are looked at collectively to determine the prognosis of the tumor.

Brain metastases are rarely reported in patients with neuroendocrine carcinoma (NEC) of non-lung origin and neuroendocrine tumors (NETs) of the gastroenteropancreatic or bronchopulmonary system. Symptomatic brain metastases are associated with a dismal prognosis, so early detection and treatment could be advisable.

The incidence of brain metastases for neuroendocrine tumors (NET) is reportedly 1.5~5%, and the origin is usually pulmonary.

NETs are considered to be the origin of brain metastases in 1.5~5% of all patients with brain metastases, and in 45–71% of these patients, the primary tumor was located in the bronchi or lungs. If brain metastases are present, lymph node metastases are found in 75% and liver metastases are found in 50% of these patients. Primary unknown NET represents just 13% of these tumors. It is difficult to detect the primary focus, especially for functional NETs, because patients have specific symptoms when the tumor size is small. Somatostatin receptor scintigraphy (SRS) is useful to detect the primary focus, especially for NET G1 and NET G2, whereas PET is more sensitive. The most widely used tracer is F18-deoxyglucose (FDG), but well-differentiated NETs do not uptake the FDG very well; therefore, 68 Ga-DOTA-TOC PET could be better for detecting pulmonary NETs. Somatostatin receptor imaging, by 111In-pentetreotide scintigraphy or PET with 68 Ga-DOTA-TOC PET, frequently identifies lesions that are not visible on other radiographic images. Currently, somatostatin receptor scintigraphy with 111In-pentetreotide is frequently available technique to determine somatostatin receptor expression. In the future, because of its higher sensitivity, 68 Ga-DOTA-TOC PET is expected to replace somatostatin receptor scintigraphy. However, 68 Ga-DOTA-TOC PET is not available in any place. So FDG-PET is easier to be performed. FDP-PET is usually sufficient for the detection of the tumor if the patient has a long-term follow-up even if the tumor is not high-grade NET.

Brain metastases are the most common intracranial neoplasm in adults. They often originate from lung cancer, breast cancer, or melanoma, but also other malignancies like renal cancer, colorectal cancer, and ovarian cancer are increasingly associated with brain metastases. Nearly 20% of the patients with small-cell lung carcinoma (SCLC) demonstrate brain metastases at initial diagnosis and about half of the patients develop brain metastases during follow-up.  In contrast, brain metastases are rarely reported in patients with neuroendocrine carcinoma of non-lung origin and neuroendocrine tumors (NETs) of the gastroenteropancreatic or broncho-pulmonary system. In the Spanish and German NET Registries, 4 of 837 (0.5%) and 12 of 2358 (0.5%) patients with brain metastases are documented. The estimated incidence in NETs is 1.5–5%.

Somatostatin and other neuropeptides are expressed in tumors originating from neuronal precursors and paraganglia, namely meduloblastoma, central Primitive Neuro-Ectodermal Tumors (cPNETs), neurocytoma, gangliocytoma, olfactory neuroblastoma, paraganglioma. In meduloblastoma, the most common malignant tumor in childhood, there is an extensive expression of somatostatin in addition to somatostatin receptors (SSTR) type 2. Although the density of SSTR-2 and intensity of expression

General screening for brain metastases is not recommended in NET and non-lung NEC patients. Whether or not prophylactic brain irradiation in limited disease NEC of gastroenteropancreatic origin could result in better prognosis like in SCLC is unknown. Symptomatic brain metastases are often associated with a dismal prognosis, so early detection and treatment could be advisable.

Somatostatin and other neuropeptides are expressed in tumors

originating from neuronal precursors and paraganglia, namely meduUoblastoma, central Primitive Neuro-Ectodermal Tumors (cPNETs), neurocytoma, gangliocytoma, olfactory neuroblastoma, paraganglioma. In meduUoblastoma, the most common

malignant tumor in childhood, there is an extensive expression of somatostatin in addition to somatostatin receptors (SSTR) type 2. Although the density of SSTR-2 and intensity of expression of somatostatin genes have no prognostic significance in medulloblastoma, their presence may bring along important information on oncogenesis and relate medulloblastoma to

cPNETs. Radio-labeled octreotide scintigraphy may be useful in the follow-up of these patients, allowing differentiation. between scar and tumoral tissue. Moreover, on the basis of octreotide-induced inhibition of cell proliferation in meduUoblastoma, a trial with octreotide in patients with recurrent or. high-risk tumour is warranted. Meningiomas and low-grade astrocytic gliomas, even if not displaying a clear neuroendocrine phenotype, have high levels of SSTR-2. In meningiomas,

Meningiomas express SSTRs in nearly 100% of cases,

both in scintigraphy and in cell culture studies. By an

in situ hybridization technique, meningiomas have been

confirmed to express only intense and homogeneous

SSTR-2.

SSTR-2A was demonstrated by immunohistochemistry

and Western blot analysis.

SSTR-2A was demonstrated by immunohistochemistry

and Western blot analysis

However, somatostatin receptor scintigraphy is not

part of the routine pre-operative work-up of a patient

suspected to have meningioma. This is partly explained

by discrepancies among different groups. While some

authors reported positive in octreotide scintigraphy in 100% meningiomas, others claimed that a low percentage of smaller meningiomas (<2.7 cm in diameter) were negative by scintigraphy.

Unexpectedly, in cultured meningiomas, somatosta-

tin and octreotide do not inhibit cell proliferation, but

rather slightly increase it, and this was accomplished

through the inhibition of adenylate cyclase. How-

ever, it cannot be excluded that somatostatin-analogues

in vivo may have antisecretory effects on para/autocrine

growth factors, such as FGF, which in turn stimulates

tumor growth . Furthermore, somatostatin-analogues, even if inactive in inhibiting proliferation, could

still play a role in meningioma therapy, contrasting

secretory phenomena associated with the formation of

edema around the tumour. In conclusion, therapeutic

trials in patients with recurrent or inoperable menin-

giomas with somatostatin analogues have to be carried

out with great caution.

Astrocytic gliomas

The majority of low-grade gliomas (WHO grade 2) and

a smaller fraction of anaplastic astrocytomas (WHO

grade 3) have been reported to contain SSTRs, as

assessed with various receptor binding techniques. Recent gene expression studies (RT-PCR ) have

shown that low-grade astrocytomas highly express

SSTR-2, alone or in combination with SSTR-1 .

while high-grade gliomas scarcely express, or do not

express, SSTR-2. Therefore, it has been supposed

that SSTRs are important only in programming cell

differentiation, and lose this significance with progressive differentiation.

Non-neoplastic cultured astrocytes express only low

levels of SSTR-1,2,4, whereas low-grade gliomas are

believed to overexpress SSTR-2, in accordance with the

overexpression of SSTRs seen in different tumours.

However, the overexpressed SSTR-2 in human glioma

cells was found to be intact (SSTR-2A splice variant is

predominantly expressed) and functional]. In fact,

no gene mutation was detected and the receptor showed

functional properties similar to those of non-neoplastic

astrocytes.

Unfortunately, use of the different expression of

SSTR-2 in low- vs. high-grade gliomas in radiolabeled-

octreotide scintigraphy is not useful in the differential

diagnosis of gliomas . Discrepancies between in vivo

scintigraphy with labelled-octreotide and the SSTRs sta-

tus in vitro were repeatedly observed. They can be

explained by the fact that in vivo uptake of radiolabeled

octreotide in gliomas is due to the disruption of the

blood brain barrier (BBB) rather than to the presence of

SSTRs [18,19]; therefore, radiolabeled octreotide cannot

reach SSTRs in astrocytoma WHO grade 2, where the

BBB is intact, while in high-grade gliomas, where the

BBB is disrupted, there is a non-specific accumulation

of the tracer. In conclusion, radiolabeled-octreo-

tide scintigraphy does not add information to routine

CTand MRI scans in the differential diagnosis of intra-

cranial lesions .

For the same reasons, radionuclide-labelled long-act-

ing somatostatin analogues also do not seem to be useful

in low-grade glioma, because the intact BBB would

prevent the therapeutic agent from reaching the target

SSTR-2.

Recently, a pilot study has proposed the use of a

radio-labelled, diffusible somatostostatin analogue in a

loco-regional approach to overcome the intact BBB. The vector, a somatostatin analogue conjugated

with the radiometal chelator DOTA (DOTATOC or

90Y-labeled DOTA°-d-Phe'-Tyr3-octreotide) was in-

serted in one to four fractions into a stereotactically

inserted Port-a-cath; the total cumulative activity was

up to 550 Gy. Selected patients had low-grade glioma

(five astrocytoma and two oligodendroglioma WHO

grade 2) or high-grade glioma (one oligodendroglioma

WHO grade 3 and three glioblastomas) with documented

disease progression, despite previous surgery, external

beam radiotherapy, brachytherapy and/or chemotherapy.

The authors did not observe any vector diffusion into

the adjacent normal brain, and reported the shrinking

of a cystic low-grade astrocytoma in addition to six dis-

ease stabilizations. Accordingly, the activity: dose ratio

(MBq:Gy) was a measure for the stability of peptide

retention in receptor-positive tissue and might predict

the clinical course. A trend toward longer progression-

free survival in low-grade glioma patients with an activi-

ty: dose ratio < 5 was observed 

The neuroendocrine system comprises a complex architecture of cells that are capable of producing NETs throughout the body. While NETs are known to develop throughout the gastrointestinal and respiratory tracts, there are only a few reports to suggest NETs originating primarily from the brain. NETs can be well-differentiated or poorly differentiated, and in the high grade poorly differentiated types, they can be a large cell

or small cell variants. The incidence of NETs has been prominently increasing over the past two decades. This is believed to be secondary to increased detection rates. Generally, the majority of NET metastases occur in the liver, lungs, and bone.Involvement of other sites is much rarer. NETs are considered to be the origin of brain metastases in 1.5-5% of all patients that.have brain metastases. In 70% of these patients, the primary

tumour was located in the bronchi or the lungs. If brain metastases are present, lymph node metastases are found in 75%, and.liver metastases are found in 50% of these patients. Primary unknown NET represents just 13% of these tumours.

Because the leading cause of death in patients with brain

NETs is secondary to systemic disease progression, the prognosis may be substantially different from metastatic brain NETs.Primary brain NETs appear to be more similar to non-metastaticNETs in which the ten-year overall survival rate is 47%

I can't breathe You're taking my life from me I can't breathe Will anyone fight with me?

 

Symptoms of a lung NET

There are 2 ways in which a lung NET can cause symptoms. A tumor itself can block the airway, causing a cough or shortness of breath. Or, hormones released by the tumor can cause carcinoid syndrome (see below). A lung NET is much less likely to cause carcinoid syndrome than a GI tract NET.

• People with a lung NET may experience the following symptoms or signs:

• Cough, with or without bloody sputum or phlegm

• Wheezing

• Post-obstructive pneumonia, which is when a tumor blocking a large air passage causes an infection

• Chest pain

• Carcinoid syndrome

Carcinoid tumor is a rare, slow-growing neuroendocrine tumor that accounts for less than 1% of all lung tumors. It occurs most commonly in the midgut, then the lung, and usually presents as a solid lesion. A patient has been reported with a typical carcinoid tumor that had undergone cystic degeneration.

Carcinoid tumors of the lung are a subgroup of neuroendocrine tumors of the lung, of lower grade than small cell carcinoma of the lung and large cell neuroendocrine carcinoma of the lung. 

For a general discussion, please refer to any article on carcinoid tumors.

Pathology

Classification

Carcinoid tumors can be divided into two groups dependent on location:

Bronchial carcinoid tumors: central lesions

Peripheral pulmonary carcinoid tumors: peripheral lesions

Carcinoid tumors also can be divided into the two groups dependent on histology (requires resected specimen rather than biopsy ) as follows:

Typical carcinoid tumors of the lung

some reports describe this type as being more common 5

low grade/well-differentiated 4 atypical carcinoid tumors of the lungless well-differentiated

more aggressive 

Cystic lung cancers are predominantly adenocarcinomas in about 80% of cases, with squamous cell carcinomas as the second most common subtype.

A rare number of other tumor types like adenosquamous, neuroendocrine, and lymphoma have been reported. 

MILD RELATIVE LYMPHOCYTOSIS NOTED . Where platelets are supposed to be max 400 mine is 399

Infection (bacterial, viral, other)

Cancer of the blood or lymphatic system

An autoimmune disorder causing ongoing (chronic) inflammation

Current research suggests that lymphopenia, defined as a low lymphocyte count, is commonly present in patients with COVID-19. There is also evidence that the degree of lymphopenia correlates with illness severity in patients with COVID-19.

Strong evidence has been accumulated since the beginning of the COVID-19 pandemic that neutrophils play an important role in the pathophysiology, particularly in those with severe disease courses. While originally considered to be a rather homogeneous cell type, recent attention to neutrophils has uncovered their fascinating transcriptional and functional diversity as well as their developmental trajectories. These new findings are important to better understand the many facets of neutrophil involvement not only in COVID-19 but also many other acute or chronic inflammatory diseases, both communicable and non-communicable. Here, we highlight the observed immune deviation of neutrophils in COVID-19 and summarize several promising therapeutic attempts to precisely target neutrophils and their reactivity in patients with COVID-

19

My past COVID has no reIationship with my lung problems here.

Multiple underlying histopathologic substrates (eg. focal tumor proliferation, fibrosis, lepidic tumor growth along alveolar walls, emphysema) relate to the imaging features of cystic lung cancer and are responsible for either the solid component, septations, ground glass, and cystic air spaces. 

The most widely quoted mechanism of air space formation is “check-valve” ventilation.

The air can enter in inspiration but cannot return during expiration due to partial obstruction of the terminal airway proximal to the cystic air space due to tumor cells and fibrosis.

This leads to development, persistency, and enlargement of the cystic air space. 

My Findings:

CHEST:

Multiple ill-defined calcified & non-calcified nodules are seen scattered in both lungs, predominantly in

upper lobes, largest measuring 2x1.3 cm in the right upper lobe.

A thin-walled cyst in the left upper lobe. Trace centriacinar emphysema in the left upper lobe. Centriacinar emphysema, is a long-term, progressive lung disease hence the FDG done without contrast to expose me to more radiation there studying the lungs in detail was neglected.

The rest of the bilateral lungs are normal in attenuation.

Trachea and mainstem bronchi are normal.

Major mediastinal vessels are normal.

Few calcified sub cm mediastinal lymph nodes. No enlarged mediastinal lymph nodes.

No pleural/pericardial effusion is seen. Bone window shows no significant abnormality.

Note is made of a few sub cm calcified foci in bilateral breasts.

Breast calcifications are calcium deposits within the breast tissue. They appear as white spots or flecks on a mammogram etc.

Breast calcifications are common on mammograms, and they're especially prevalent after age 50. Although breast calcifications are usually noncancerous (benign), certain patterns of calcifications — such as tight clusters with irregular shapes and fine appearance — may indicate breast cancer or precancerous changes to breast tissue.

Some patients may have several years’ delay in the correct diagnosis due to misdiagnosis as asthma. I am a victim of misdiagnosis.Like other neuroendocrine tumors, lung carcinoids may secrete hormones. Endocrine symptoms are however rare. Despite serotonin, immunoreactivity is present in up to 84% of the tumors.

• With dry cough and 

• progressive dyspnea ( Shortness of breath)

•  I get to know CHEST:

"Multiple ill-defined calcified & non-calcified nodules are seen scattered in both lungs, predominantly in

upper lobes, largest measuring 2x1.3 cm in the right upper lobe.

A thin-walled cyst in the left upper lobe."

Early lung cancers associated with cystic airspaces are increasingly being recognized as a cause of delayed diagnoses—owing to data gathered from screening trials and encounters in routine clinical practice as more patients undergo serial imaging. Several morphologic subtypes of cancers associated with cystic airspaces exist and can exhibit variable patterns of progression as the solid elements of the tumor grow.

It was identified and assessed 30 lung cancers from a total of 2954 primary lung cancers diagnosed at their institution. In these 30 cases, cysts were in or adjacent to the cancers at some point leading up to the histologic diagnosis. In 20% of the cases, the cystic airspace was multilocular when it was first identified. Twenty-five percent of the remaining cystic airspaces that were unilocular at first visualization evolved to have a multilocular appearance over the course of observations. None of the initially multilocular lesions evolved to have a unilocular morphology.

Lung cancers arising from bullous emphysematous disease also are the subject of a number of anecdotal case reports, as well as a study whose results indicated “poorer cell differentiation and accelerated proliferative activity” in lung cancer arising from emphysematous bullae.

Lung carcinoid tumors are quite rare, accounting for only 1% to 2% of all lung cancers.

In the most basic terms, there are calcified nodules and non-calcified nodules. 

Calcified nodules contain deposits of calcium which are visible on imaging scans. 

The finding of a SPN (Solitary Pulmonary Nodule)usually provokes a flurry of clinical and imaging activity as an SPN in an at-risk population is an alert signal of possible lung cancer. The frequency of malignant nodules in a given population is variable and depends on the endemicity of granulomatous disease. The percentage of malignant nodules also rises when dealing with at-risk populations. The problem is compounded by the fact that with the present generation of CT scanners, 1–2 mm nodules are discovered.

Calcification in a pulmonary nodule (PN) on imaging indicates a high probability that the lesion is benign. But not all calcified PN are benign and the differential considerations include a primary central lung carcinoid, metastasis, and a primary bronchogenic carcinoma. The widespread use of computed tomography (CT) has increased the sensitivity of detecting calcification in malignant tumors. Radiological demonstration of calcification in lung cancers is uncommon but when encountered may lead to misdiagnosis. Amorphous, punctate, and reticular patterns of calcification have been described in lung cancer. Malignant tumors may engulf a pre-existing granuloma, or tumor necrosis can manifest as tumor dystrophic calcification. Calcification in a mucinous adenocarcinoma may occur as a primary phenomenon. In a malignant PN, calcification appears in the form of larger lesions and is usually stippled or eccentric. To classify calcification in a benign PN certain criteria need to be fulfilled. Benign calcification should encompass over 10% of the PN and calcification should be central, diffuse, popcorn type, or laminated. To complicate matters malignant nodules may mimic the appearances of benign calcified granuloma... Six different patterns of calcification in a PN are known:

 (I) central dense nidus 

(II) diffuse solid

 (III) laminated

 (IV) popcorn

 (V) punctate and

 (VI) dendriform.

CT densitometry has been shown to have limited value when assessing spiculated nodules and its sensitivity (66%) and specificity (98%) for benign disease are not optimal.

Differential diagnosis of diffusely distributed small calcified nodules includes

infections,

lung metastases,

chronic pulmonary hemorrhage,

pneumoconiosis,

deposition diseases,

and idiopathic disorders such as pulmonary alveolar microlithiasis. It is imperative that before embarking on the workup of a high-density nodule that an extrinsic thoracic wall lesion is excluded.

Non-calcified nodules are classified as ground-glass opacities, partially solid or solid nodules. Ground glass opacities (GGO) look like a hazy (not clear) area 

on a CT scan, like ground glass. This may be the result of inflammation caused by infection or other lung damage, but could also be a sign of a type of lung cancer that is slow-growing.

If the nodule grows, further testing may be needed to see if it is cancer. 

By definition, a lung nodule is a rounded or irregular opacity, which may be well or poorly defined,

measuring ⩽3 cm in diameter, surrounded by aerated lung on radiological imaging.

With regard to SSNs, visual evaluation is a difficult task as nodule margins tend to be ill-defined and have

a low contrast concerning the surrounding lung parenchyma. In this context, uncertainties exist not

only in the nodule measurement, due to difficulties in delineating nodule margins and different

densitometric components of PSNs, but also in the classification of nodule morphological characteristics.

Chest CT with a mediastinal window and coronal reconstruction, showing calcifications affecting lymph nodes of several mediastinal and hilar chains. Note that several of them present calcifications predominantly in their periphery-“eggshell” calcifications.

Lymph node calcifications most often result from prior granulomatous infections, especially tuberculosis and histoplasmosis. Other, less common, causes are sarcoidosis, silicosis, amyloidosis, and calcifications secondary to the treatment of lymphomas (radiation therapy or chemotherapy). However, the patient in question had lymph node calcifications with characteristics that made them more specific. The calcifications involved lymph nodes of multiple chains, including some that presented eggshell calcifications.

When calcifications affecting multiple chains are observed, two diseases top the list of differential diagnoses: silicosis and sarcoidosis. Differentiation by imaging can be very difficult, because both diseases can present with small nodules, conglomerated masses, and areas of emphysema. It is therefore fundamental to investigate the clinical history of exposure to silica dust, given that most patients with silicosis have engaged in professional activities related to such exposure. Although a patient was a female and almost all cases of silicosis occur in male patients, she reported that she had been working at a lapidary, processing semiprecious stones, for 25 years. A diagnosis of silicosis was therefore made.

Silicosis is a chronic fibrotic lung disease caused by prolonged exposure to dust-containing free silica. The diagnosis of silicosis is based on the combination of a history of exposure to silica and characteristic findings on imaging tests. Mining, quarrying, drilling (wells, tunnels, and galleries), ceramics work, marble work, sandblasting, and artisanal work with semiprecious stones are all common professional activities in Brazil.

The classic radiological findings are small nodules, typically located in the posterior and upper lung regions, which can be disseminated through the lungs. The nodules can agglomerate, forming conglomerate masses. The most common lymph node involvement occurs in the form of calcifications in multiple lymph node chains. The past and present occupation of the patient is decisive for the final diagnosis of silicosis.

This is mentioned in my general discussion of lung cancer not my own findings.

Keep me you say you won't return me

 

Never afraid of challenges

 With bronchial asthma and intrapulmonary metastases

Stood up for what is right

With all her might.

Telling wrong from right.

As clear as daylight

Mum has lots of love to give

Show me someone who knows how to live 

With patience,. It takes responsibility and dedication

Gushing with joy expecting nothing in return

When opportunities arise there's no success without effort

Walking my own path nevertheless not knowing why but effortlessly

Believing in changing an imperfect word to a world

Hoping happiness at the end of the day

Why does everything go wrong being optimistic and gay

My vision is a perfect world

A change from an imperfect world

Where happiness and hope rules

Game of Life is about the needed machinery 

Of  the moment and it's many human parts

With a happy middle without an end 

Joy lying to pounce on you at the end of your journey

Right or wrong in any matter fixed by mother

In a stormy weather I tell Mum ' Keep me you say you won't return me, eh?

Let that be our track and it will happen'