Correct!
3. Thoracic CT

Thoracostomy tube insertion would be indicated for pneumothorax or pleural effusion evacuation, but neither are present in this case. Cervical mediastinoscopy is typically used for sampling enlarged mediastinal lymph nodes, as may occur with lung cancer staging, or sampling indeterminate mediastinal masses, but neither are considerations for this patient. Video-assisted thoracoscopic investigation of the left pleural space would be employed for diagnosis or management of pleural effusions, sampling left-sided mediastinal lesions or lymph nodes in contact with the pleura (as may occur with lung cancer staging), resection of indeterminate lung nodules or small, localized primary lung malignancies, bullectomy in cases of spontaneous pneumothorax, etc., but these considerations are not relevant to this patient. 18FDG-PET scanning would not provide useful information for this patient.

The patient underwent enhanced thoracic CT (Figure 2) to further characterize the lesion found at chest radiography.

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Figure 2. Left: Representative static images from the axial thoracic CT in lung windows. Right: video of thoracic CT in lung windows.

Which of the following is correct regarding the description of the thoracic CT findings? (Click on the correct answer to proceed to the fifth of eight panels)

  1. The frontal chest radiograph shows developing cavitation in the lung parenchyma
  2. The frontal chest radiograph shows interval worsening of bilateral consolidation and ground-glass opacity
  3. The frontal chest radiograph shows intrathoracic herniation of the stomach
  4. The frontal chest radiograph shows the “fallen lung” sign
  5. The frontal chest radiograph shows worsening subcutaneous emphysema and pneumomediastinum

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