Correct!
2. The contrast-enhanced thoracic CT shows abnormal right bronchial and mediastinal soft tissue
The contrast-enhanced thoracic CT shows extensive left lung volume loss, but the volume loss is neither due to active endobronchial obstruction (the central airways bilaterally are patent) nor pleural thickening causing visceral pleural restriction (no pleural abnormality is seen on either side). Although the right pulmonary artery is clearly diminutive, no dissection or intrinsic abnormality of this vessel is seen. The left lung is entirely normal. The volume loss within the right thorax, evidenced by shift of the cardiomediastinal structures towards the right, is due to an intrinsic abnormality on that side, and is not the result of a space-occupying process, cystic or otherwise, on the left side. The contrast-enhanced thoracic CT does show abnormal soft tissue in the right peribronchial region and right mediastinum, extending into the subcarinal space and azygoesophageal recess and long the right aspect of the left atrium. The lung windows of this study show extensive reticulation and interlobular septal thickening through the hypoplastic-appearing right lung.
No prior imaging was available for the patient.
Which of the following represents the most appropriate next step for the managementof this patient? (Click on the correct answer to proceed to the sixth of nine pages)