An 85-year-old man presents with progressive dyspnea, fatigue, and anorexia for three months. He also experienced pain in the lower right side of his chest during this time.

He was a shipyard worker for 30 years, retiring at the age of 55.

His medical history is unremarkable. There is no family history of lung disease.

He appears in mild respiratory distress. He is afebrile. His blood pressure is 110/70 mmHg, his heart rate is 98 bpm, his respiratory rate is 22 breaths per minute, and his oxygen saturation is 94% on room air.