A 74-year-old man was referred to the pulmonary clinic for a right upper lobe mass on CT scan. He initially presented to his primary care provider 6 months prior with subacute onset of shortness of breath, sinus pressure, and fatigue. He was given azithromycin and fluticasone/salmeterol for community-acquired pneumonia and asthma, respectively, with improvement. He returned to his primary care provider 5 months later, complaining of dyspnea on exertion, fever, chills, drenching night sweats, anorexia, pleuritic chest pain, and 20-pound weight loss over the previous 8 weeks. He was given moxifloxacin with no improvement. A chest radiograph revealed a right upper lobe mass confirmed on CT scan, which prompted the referral.