An 80-year-old woman with a medical history significant for a recent porcine aortic valve replacement was referred to the pulmonary clinic for a new 2-cm right lower lobe (RLL) nodule found on a follow-up chest radiograph (Fig 1) after surgery. She denied fever, chills, or weight loss. She had mild dyspnea on exertion. She denied chest pain, orthopnea, cough, or hemoptysis. The findings of a review of systems were otherwise unremarkable.