Question: A 50-year-old Hispanic man with history of smoking, chronic obstructive pulmonary disease, chronic pancreatitis, congestive heart failure, and recurrent deep vein thrombosis on anticoagulation therapy was admitted with worsening shortness of breath and upper abdominal and chest pain for 3 days. The patient had chronic abdominal pain, occasional productive cough and had lost 50-lb weight over the last 6 months. He denied fever, night sweats, difficulty swallowing, vomiting, or diarrhea.