A 65-year-old white woman was evaluated for a solitary pulmonary nodule. While undergoing a commercial whole-body CT screening examination 1.5 years earlier, she was found to have a 9-mm poorly marginated lesion in the right lower lobe of her lung. A short-term follow-up and/or diagnostic evaluation was strongly recommended, but the patient deferred. During the current evaluation, a follow-up chest CT scan demonstrated the presence of a 16-mm nodule in the right lower lobe with irregular margins (Fig 1
). The patient denied dyspnea, fever, cough, hemoptysis, or weight loss. Her medical history was only pertinent for type II diabetes mellitus, hypertension, and hypercholesterolemia. Two years earlier, she had undergone a total abdominal hysterectomy with bilateral salpingo-oophrectomy for treatment of a borderline stage IA ovarian tumor. The patient had a remote cumulative 25-pack-year smoking history. Her family history was negative for cancer or lung disease.