A 62-year-old woman who has had a chronic cough for years becomes short of breath after climbing a single flight of stairs. A chest radiograph performed 1 year ago showed increased lucency of upper lung fields and bilateral flattening of the diaphragmatic leaves. She has had nausea and vague abdominal discomfort for 6 months. Biopsy specimens from an upper gastrointestinal endoscopic study show a chronic nonspecific gastritis with no detectable Helicobacter pylori organisms. During the past month, she has passed red-colored urine on several occasions. Cystoscopic examination shows a 3-cm exophytic mass in the dome of the bladder, and biopsy specimens show a transitional cell carcinoma. Which of the following is most likely to lead to this spectrum of findings?
Pathology revision series will continue till May INI. Since the pattern is not yet clear by AIIMS, I shall be adding more questions post the real exam and will continue discussion till next INI - Subscribe here today