Correct!
2. Mucinous adenocarcinoma of the lung
All of the entitles listed can cause chronic, non-resolving opacities at chest imaging; however, mucinous adenocarcinoma, which can appear as areas of consolidation rather than the typical focal nodule or mass, or multiple nodules or masses, associated with bronchogenic malignancy, generally will not cause transient and migratory opacities that entirely resolve in some areas of lung. The other listed entities are well-known to cause multifocal, bilateral, frequently peripheral and often frankly subpleural, areas of ground-glass opacity and consolidation that transiently involve one area of lung and then migrate to involve a different region of lung.
The patient’s anti-nuclear antibody level was within the normal range. Gastrointestinal medicine was consulted and expressed concern for silent reflux with micro-aspiration, but endoscopy and esophageal pH monitoring and a barium esophagram showed no evidence of reflux.
Which of the following courses of action is the most appropriate next step for the management of this patient? (Click on the correct answer to be directed to the eleventh of twelve pages)