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Old 05-25-2012
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Lungs Another solitary pulmonary nodule question

A 63-year-old man is found to have a 1.5-cm spiculated, noncalcified nodule in the right upper lobe of the lung on chest radiograph performed before elective resection of the sigmoid colon for recurrent diverticulitis. There is no lymphadenopathy or evidence of calcified lymph nodes. A chest radiograph obtained 15 years ago does not show the nodule. The patient is a life-long nonsmoker and has no occupational risks for lung disease. Other than recurrent diverticulitis, he is healthy and takes no medication.

Which of the following is the best management option for the pulmonary nodule?

A Biopsy of the nodule
B Positron emission tomography of the chest
C Repeat chest radiography in 6 months
D Spiral CT scan of the chest
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Old 05-25-2012
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Since he is >50 yr
Prior CxR did not show any nodule.
The feature of the nodule pointing to the malignancy:
1. Size > 1cm
2. Spiculated
3. Non-calcified
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Old 05-25-2012
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Solitary Pulmonary Nodule Calculator
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Old 05-25-2012
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Also i will go with bx too , but the size here i think its borderline, cuz the high risk is considered > 2cm
And dont tell me PET scan :d is the ans
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Quote:
Originally Posted by Novobiocin View Post
i agree with that.

dont we do spiral CT scan prior to doing biopsy?

i say that because that will give us clear picture of lungs...ie...any other spn missed by cxr...so i went for CT scan. please reply.
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Quote:
Originally Posted by tyagee View Post
i agree with that.

dont we do spiral CT scan prior to doing biopsy?

i say that because that will give us clear picture of lungs...ie...any other spn missed by cxr...so i went for CT scan. please reply.
The question asks for "best management option" not the next step in management.
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