A 29-year-old African-American woman with a history of cerebrovascular accident presented with new onset right hemiparesis. On physical examination, digital clubbing (Figures 1 and 2), left-sided weakness with spasticity (Figure 2), and upper lip telangectasia (Figure 1) were noted. Chest radiography and computed tomography of the chest were performed (Figures 3 and 4).

Author information: Dr Adriano R Tonelli. Pulmonary and Critical Care Fellow, University of Florida, Gainesville, Florida, USA

Correspondence: Dr Adriano Tonelli, Health Science Center, 1600 SW Archer Road, Room M452, Gainesville, Florida, USA. Fax: +1 (0)352 3920821; email: Adriano.Tonelli@medicine.ufl.edu