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Trapped by an incidental finding.

The step-by-step process of clinical problem-solving is the subject of this new Journal feature. Information about a real patient is presented to an expert clinician in stages (boldface type), to simulate the way such information emerges in everyday clinical practice. The clinician responds (regular type) as each piece of information is presented, sharing his or her reasoning extemporaneously with the reader. An analysis of the process follows. Our purposes in introducing this new feature are discussed in an editorial on page 60. A 74-year-old retired attorney, when seen in routine follow-up by his primary care physician, mentioned that he had . . .