A 64-year-old woman with a 30-year history of smoking presents with hemoptysis and a right lower lobe nodule on chest CT. She has palpable lymphadenopathy in the right axilla. Excisional biopsy of the lymph node shows hyperplasia with preserved architecture and reactive germinal centers. Which of the following is the next best step in diagnosis?
- A)Order PET-CT to stage suspected malignancy
- B)Observe with serial imaging for 3 months
- C)Initiate chemotherapy for presumed lymphoma
- D)Repeat excisional biopsy or FNA of the lung noduleGABARITO
- E)Perform bronchoscopy with bronchoalveolar lavage
Explicação
The lymph node shows reactive hyperplasia, not lymphoma. Given the lung nodule in a smoker with hemoptysis, the primary concern is lung cancer. The axillary lymphadenopathy is likely reactive (regional response). Tissue diagnosis of the lung lesion is needed t... Ver explicação completa e trilha adaptativa →