A 79-year-old woman was referred to the pulmonary clinic for evaluation of a right paratracheal mass identified on a chest radiograph obtained for cancer monitoring. She was a never-smoker who had been treated 15 years before for early-stage breast cancer without lymph node involvement with a right mastectomy. She had not received radiation therapy or chemotherapy postoperatively; however, she did receive tamoxifen for 5 years. On review, the patient was without shortness of breath, cough, hemoptysis, fever, or weight loss. She denied recent pneumonia, chest trauma, or exposure to asbestos, tuberculosis, or birds. A tuberculin skin test result had been negative 5 years before. Although she previously had lived in North Carolina and had moved to South Carolina 2 months ago, she had no other travel history.