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Fig. 4. —64-year-old man who underwent right nephrectomy for renal cell carcinoma and developed cough and hemoptysis. He was afebrile, and results of coagulation studies were normal. Contrast-enhanced helical CT scan shows bilateral lower lobe metastases and left lower lobe air-space opacity near largest mass. Air-space process rapidly and completely resolved, indicating spontaneous hemorrhage. Note left coronary artery calcification.