A 52 year-old male was admitted to our hospital because of “intermittent fever, cough and sputum, chest pain for 2 months”.

2 months ago, the patient went to bed after drunk. When he got up, he began to fill tired and have fever (peak temperature 38.8℃). He had cough and purulent sputum at the same time. The sputum was not fetid. He went to the local hospital and was given some medicine (no details). However, the symptoms had no change. 50 days ago, the symptoms were aggravated with left chest pain, the amount of sputum was about 30-50ml/day. He had no hemoptysis. He went to the local hospital and chest X-ray showed “pneumonia”. Some antibiotics were given and the temperature went back to normal. Cough and sputum was alleviated. Because of persistent left chest pain, he took chest X-ray again 1 week ago, and it showed the lung shadow was worse. He was admitted to our hospital for further diagnosis and treatment. He had no nausea, vomiting and night sweats. His sleep and appetite were normal. His stool and urine were normal too. The body weight decreased 2-3 kg.

Past history: He had chronic hepatitis B many years. There was nothing else abnormal in the case history review. He had no history of drug allergy. He had history of cigarette smoking for more than 30 years, 20/day. He drank alcohol 250ml per day for more than 30 years. Family history was nothing special.

Physical Examination：T37.2℃, P96/min, R19/min, BP125/85mmHg. The patient was well developed and moderately nourished. He was mentally normal and cooperative in the examination. There was no jaundice, no purpura on the skin, and the lymphnodes were not palpable. His head, eyes, nose, ears, mouth were normal. His neck was soft, and no venous engorgement. Thyroid glands were not palpable. The trachea was in midline. The chest and respiratory movements were symmetrical. There was no abnormal dullness. No abnormal breath sound. The heart rate was 96/min, regular. No pathological heart murmur. No pericardium friction sound was heard. Abdominal wall was soft without tenderness. The liver and the spleen were not palpable and there was no shifting dullness. No edema in her lower extremities, and no swelling knees.

Laboratory tests:

Blood routine test: WBC 11.0×10⁹/L, N 78.6%

Urine routine test: normal

Questions:

1. What is the diagnosis for this case?

2.