Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors
The patient is an 84 year old man who presents with small amounts of hemoptysis for one week prior to admission. He is a life-long non-smoker who began having cough with sputum production for one year without fever, chills, nightsweats, orthopnea, weight loss, arthralgias or rash. The patient denied unusual occupational exposures, history of prior TB, travel, or owning pets. The past medical history was significant for coronary bypass surgery, hypertension, atrial fibrillation treated with aspirin, and diabetes mellitus. A recent echocardiogram was unremarkable.
Chest film and chest CT are shown below: