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Case 112: Farmer for surgery

A 72 year old farmer is seen in the pre-anaesthetic clinic for a check prior to inguinal hernia repair. A chest xray is requested as he has a smoking history. An interesting incidental discovery is made.
Note that the image contrast has been manipulated to best show the abnormality.

1. What is the finding and the likely diagnosis?

2. What further investigations would you arrange?