Case #37: The breathless swollen man

This elderly man presents with gradual weight loss over the last few months and progressive shortness of breath.
On examination, he is cachexic and tachypnoeic. His left arm appears to be bigger than the right and there is an ulcerated swelling over his left shoulder. Hard nodes are palpable both in the left cervical region as well as the left axilla.

These are his pictures:

Questions:

1. Describe the findings in the pictures.

2. Describe the findings in the CXR.

3. What are the differential diagnoses?

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