63 yo lady, ex-smoker, with moderately severe airways disease, was found incidentally to have a 13mm intensely FDG-avid nodule in the lateral segment of the right lower lobe. An attempt at CT-guided needle biopsy was non-diagnostic. Spirometry: FEV1 1.38L, 49% predicted. She was obese. ECOG 1. We performed a sublobar resection given her limited lung reserve. She did well and was discharged home on the fourth post-operative day. Her final histopath revealed a adenocarcinoma of the lung with a maximum dimension of 23mm, T1cN0M0, with clear resection margins.