A 46-year-old Guyanese-born woman was referred for a chest radiographic abnormality and a 3-week history of dry cough. She denied having shortness of breath, chest pain, fever, chills, or hemoptysis. There was no history of paroxysmal nocturnal dyspnea, orthopnea, or reflux, and her exercise tolerance was normal. She was a lifelong nonsmoker with a 15-year passive exposure to cigarette smoke. She worked as a dietary aid in a nursing home, had a positive purified protein derivative reported 12 years previously, and had undergone bacille Calmette-Guérin vaccination as a child. Type 2 diabetes mellitus diagnosed 9 years previously was controlled by oral hypoglycemic medications. She reported an asymptomatic chest lump, first detected approximately 4 years prior, that had not apparently changed in size. There was no history of chest or other trauma. Her surgical history included a hysterectomy at age 36 years for endometriosis, a left breast lumpectomy for a benign lesion, and bilateral cataract surgery.