A 70-year-old man is referred by his primary care physician, after a chest x-ray obtained last week showed a solitary pulmonary nodule. He has had sporadic mild hemoptysis for 2 months and a worsening cough for 1 year.

His medical and surgical histories are unremarkable. He is not on any medications currently. He stopped smoking 5 years ago, but had smoked a total of 50 pack years until then.