Correct!
5. Thoracic CT
The right thoracic lesion was fairly well seen at the abdominal CT and MR examinations, but it would be useful to determine if other sites of disease are present to formulate differential considerations and develop an approach to establishing a diagnosis. Inspiratory and expiratory radiography is primarily used for detection of pneumothorax or to assess for air trapping, such as in the context of a suspected foreign body within the large airways, and would not play a role here. 68Ga-citrate scintigraphy is occasionally used for assessment of diffuse lung opacities, perhaps to detect opportunistic infections in immunocompromised patients, or pneumonitis related to medication-induced pulmonary injury, but neither are appropriate considerations for this patient. 99mTc-MAA ventilation-perfusion scintigraphy is useful for the detection of suspected thromboembolic disease but pulmonary embolism is not highly suspected in this patient as the morphology of the right thoracic lesion is not suggestive of an infarct; therefore 99mTc-MAA ventilation-perfusion scintigraphy is not the most appropriate next step. Lateral decubitus thoracic CT can be useful to assess for the mobility of pleural liquid or to assess for pneumothorax or air trapping, but these are not relevant diagnostic considerations for the mass in this patient.
The patient underwent contrast-enhanced thoracic CT (Figures 4 and 5).
Figure 4. Left: representative images of the axial enhanced thoracic CT . Right: movie of the axial enhanced thoracic CT.
Figure 5: Sagittal enhanced thoracic CT.
Which of the following statements regarding the thoracic CT is most accurate? (Click on the correct answer to proceed to the sixth of nine panels)