A 56-year-old man presents with dyspnea, wheezing, and chest pain. He has a 9-year history of moderate chronic obstructive pulmonary disease (COPD), which he manages with bronchodilators. The patient began smoking in high school and continued through adulthood but quit when he began pulmonary rehabilitation for COPD with the help of nicotine patches. His wife, however, still smokes. He has low pulmonary reserve and hypercalcemia. Because of the patient's history and other risk factors, chest radiography was ordered; it showed a cavitary lesion in the lower part of the left lung, abutting the left lower lobe bronchus, with pleural effusion and volume loss.