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Bronchogenic Carcinoma

Solitary 2

Step 1: View clinicals

A 70 year old man is referred by his primary care physician, after his chest x-ray was found to show a solitary pulmonary nodule. His history is significant for a worsening cough for 1 year, and sporadic, mild hemoptysis for 2 months. He stopped smoking 5 years ago, after consuming a total of 50 pack years.

Step 2: Order all relevant investigations

X-Ray Chest

A homogenous ovoid nodule measuring approximately 2cm x 1cm in size is present in the right upper lobe.

Contrast CT Chest

A centrally located, ovoid nodule of 2 cm x 1cm is seen in the right upper lobe with partly solid attenuation and air bronchograms; the margin is lobulated. No mediastinal lymphadenopathy is seen.

FDG-PET scan

The FDG-PET scan shows a circumscribed area of high uptake in the right upper lobe.

Transbronchial Biopsy

The transbronchial fine needle aspiration biopsy is suggestive of primary squamous cell carcinoma of the lung.

Step 3: Select appropriate management

Surgical Resection
Antituberculous Therapy

Score: ★★☆