50 yr old with history of cigarette smoking presents with a 3.3 cm right hilar mass. Physical exam is unremarkable. He has no headache or neurological deficits. Bronchoscopic biopsy reveals small cell lung cancer.
CT scan of the chest and upper abdomen reveals enlarged right sided mediastinal lymph nodes measuring up to 2.6 cms in size. PET/CT scan shows activity in the R hilar lesion and the mediastinal lymph nodes with an SUV of 11.3 without evidence of distant metastatic disease. MRI of the brain with gadolinium is negative.