A 59-year-old man was referred to the Lung Mass Clinic for an abnormality found on a routine chest radiograph. He had experienced gradually progressive exertional dyspnea for > 5 years and had a chronic nonproductive cough. He denied fevers, weight loss, chest pain, or hemoptysis. He had gastroesophageal reflux disease, for which he was receiving therapy with omeprazole. He was a 60-pack-year current smoker and consumed at least one six-pack of beer per week. He had served in Vietnam in the US Navy and was currently working as a respiratory therapist.