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Pulmonology Quiz

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53 yr old presents with a 3 cm left upper lobe mass noted on CT scan of the chest. This was obtained after he presented with 2 months of cough and an abnormal chest x-ray. He has a 40 year history of smoking two packs of cigarettes a day.  He denies other symptoms and has been in reasonable health aside from COPD.

CT guided biopsy reveals moderately differentiated adenocarcinoma. PET/CT scan of the body shows uptake in the ipsilateral mediastinal lymph nodes. These are confirmed to be pathologically involved by cancer by mediastinoscopy.  He is staged as a IIIA lung cancer.


Of the following options, the next step in his management would include all of the following except:

  1.  MRI of the brain with gadolidium
  2.  Bronchoscopy
  3.  Pulmonary function tests
  4.  Bone scan