Correct!
5. Adenocarcinoma is the most common lung cancer seen in nonsmokers

Lung cancer is seen in nonsmokers especially those with positive risk factors including exposure to second hand smoke or other carcinogens and a family history (1). Larger masses are more likely to be lung cancer than smaller masses (<2 cm). Central calcification of a lung mass is indicative of a benign lesion. Adenocarcinoma is the most common tumor type seen in nonsmokers.

The patient refused a biopsy but did consent to a follow up CT scan in 3 months which revealed enlargement of the mass (Figure 1).

Figure 1. Representative image from the repeat CT scan.

Which of the following should be done at this time?

  1. Evaluation of the left pleural effusion for metastatic disease
  2. Left pneumonectomy
  3. Bronchoscopy
  4. Endobronchial ultrasonography to sample mediastinal lymph nodes
  5. Bone scan to evaluate for metastatic disease
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