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Pulmonology Quiz


Question Information

 
Question Date:
  06/29/2010
Submitted by:
  Administrator
Affiliation:
  QuestionPursuit

Question

 

50 yr old with history of cigarette smoking present with a 2.8 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 2 cms in size.  PET/CT scan shows activity in the R hilar lesion and the mediastinum with an SUV of 11.3 without evidence of distant metastatic disease.

 

Of the following options, the next best step in the management of this patient is:

  1.  Chemotherapy followed sequentially by radiation to the R hilum and mediastinum
  2.  Radiation followed sequentially by radiation to the R hilum and mediastinum
  3.  Concurrent chemoradiation to the R hilar mass and mediastinum
  4.  MRI of the brain with gadolinium