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5. Solitary fibrous tumor of the pleura
The right thoracic lesion is a solitary, indolent-appearing mass with extensive pleural contact, the latter feature suggesting a pleural or chest wall origin, rather than a pulmonary origin, as would be the case for bronchogenic malignancy. The lesion shows no locally aggressive behavior. These features would not be expected for metastatic disease (and the patient has no evidence of primary malignancy outside the thorax), bronchogenic malignancy, or malignant pleural mesothelioma. The described features are, however, quite typical of solitary fibrous tumor of the pleura. Neurogenic lesions are typically located in the posterior mediastinum when arising within the thorax, and therefore would be expected to have a closer association with the spine. It is possible that a neurogenic tumor arising from the intercostal nerve could have an appearance similar to this lesion, although such neurogenic lesions are usually smaller and rounded or more elliptical / lenticular in appearance rather than the lobulated morphology displayed by the lesion in this patient. Further, the sagittal CT imaging shows the right thoracic lesion in this patient to conform very closely to the posterior pleural space, which favors a pleural origin for the lesion.).
Based on the data thus far, which of the following represents the next most appropriate step for the evaluation of this patient? (Click on the correct answer to procced to the ninth and last panel)