Correct!
3. There is now definite lung involvement on the left

The calcium present in the left hilar region is small, eccentric and likely old. While eccentric calcification within a nodule suggests the nodule is more likely benign than malignant, eccentric (and stippled) patterns of calcification within pulmonary nodules can be seen in malignancies. The presence of bilateral hilar enlargement might make sarcoidosis more likely but unilateral enlargement would not exclude the diagnosis. There is now definite lung involvement on the left which is new compared to the previous CT scan.

Which of the following are indicated at this time? (Click on the correct answer to proceed to the fourth of seven pages)
  1. Bronchoscopy with endobronchial ultrasound (EBUS)
  2. Continued observation
  3. Needle biopsy
  4. PET/CT scan
  5. Video assisted thorascopic biopsy (VATS)

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