Patient History

A 43 yr.-old white male presents to the Emergency Department complaining of persistent cough, hemoptysis and occasional shortness of breath. The patient has a 1.5 pack per day history of smoking, as well as a 22-yr history of a 12 pack of beer per week. The patient also notes an unintentional weight-loss of 10-13 pounds over the last six months. He has also worked as a coal minor for the last 20 years. Family history is significant for a father with “bone cancer” and a mother with “vaginal cancer.” The patient also has a one-year history of peptic ulcer disease that was initially treated with proton-pump inhibitors, however he has not stayed current with the medication and consequently lives with chronic heartburn. The patient is sent for a computed tomography (CT) scan with contrast.