• Woon H Chong, Ammoura Ibrahim, and Biplab K Saha.
• Department of Pulmonary and Critical Care, Albany Medical Center, Albany, NY. Electronic address: Keenanchong15@gmail.com.
• Chest. 2021 Mar 1; 159 (3): e147-e150.

Case PresentationA 69-year-old woman with a medical history significant for COPD, ulcerative colitis (UC), and tobacco dependence was referred to a pulmonologist for lung nodules found on routine annual low-dose CT scan for lung cancer screening. Her review of systems was negative for dyspnea, angina, hemoptysis, fever, night sweats, anorexia, and weight loss. She had a successful total proctocolectomy with ileal pouch-anal anastomosis performed 5 years ago because of acute fulminant UC refractory to corticosteroids and biologic agents. Her home medications were albuterol inhaler, umeclidinium, and vilanterol inhalation powder. She denied any history of lung cancers in her family. She was an active smoker and had a 35-pack-year smoking history. She worked as a cashier in a local supermarket and had been doing so for the past 25 years.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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