A 71-year-old female presents to her primary care physician with an 8-week history of cough with intermittent blood-tinged sputum. She reports a 20-pound weight loss and increasing fatigue over the last three months. She denies fevers or sick contacts. She is a current smoker with a 40-pack-year smoking history. She previously worked as a welder in a shipyard for 30 years before retiring five years ago. Her past medical history includes hypertension. Breath sounds are equal without crackles. Cardiac exam reveals a regular rate and rhythm. Her blood pressure is 120/80 mmHg, and her heart rate is 88/min. An initial chest x-ray reveals blunting of the right costophrenic angle, an enlarged cardiac silhouette, and a mass in the right hilar region measuring 3.1 cm × 3.5 cm.