一位84岁的女性前往介入性肺科门诊进行评估，以确定右中叶肺部肿块的情况。她的病史包括房颤并服用利伐沙班药物，以及反复发作的双侧乳腺癌，该癌症需要多次肿瘤切除术、放疗和化疗。她曾经吸烟五年。两个月前，她曾在外部医疗机构接受了左右心导管检查，以评估呼吸急促的情况，结果显示少量冠状动脉疾病，但肺动脉压力为55 / 24mm Hg。手术本身并发咳血，需要住院观察。在住院期间，她进行了胸部X射线检查（图1），但没有可供比较的最新影像。她被门诊肺病专家看诊，并接受了支气管镜检查和支气管刷检查，疑虑恶性肿瘤。结果不具备诊断价值。随后，她被转诊到介入性肺科服务进行进一步评估。 版权所有©2022美国胸科医师学院。由Elsevier Inc.出版。保留所有权利。

An 84-year-old woman presented to the interventional pulmonary clinic for evaluation of a right middle lobe lung mass. Her medical history was notable for atrial fibrillation on rivaroxaban and recurrent bilateral breast cancer that had required multiple lumpectomies, radiation, and chemotherapy. She is a former smoker of five-pack years. She underwent a right and left heart catheterization at an outside facility 2 months prior to her presentation for evaluation of dyspnea that showed minimal coronary artery disease but elevated pulmonary artery pressures of 55/24 mm Hg. The procedure itself was complicated by hemoptysis that required hospital admission for observation. She underwent a chest radiography during her hospitalization (Fig 1) There was no recent imaging for comparison. She was seen by a pulmonologist as an outpatient and underwent bronchoscopy with BAL and bronchial brushing for concerns of malignancy. The results were not diagnostic. She was then referred to the interventional pulmonary service for further evaluation.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.