Correct!
4. The thoracic CT shows multiple peripheral nodules with and without cavitation
Figure 4. Static thoracic CT images.
Thoracic CT in the axial planes shows multiple, bilateral, peripheral opacities, many with a nodular appearance (arrows). Some of the opacities show internal lucency, consistent with cavitation, but the wall thickness of such lesions (arrows, Figure 3C) is best characterized as indeterminate, or frankly thick-walled, and not as thin-walled cysts. The nodules present are mostly large than the 1-2 mm typical of miliary nodules. The central airways appear normal- no bronchiectasis or bronchial impaction is apparent. While a small right and trace left pleural effusions are present, the effusions have a “meniscus” appearance, and the convex or lenticular shape that may suggest loculation is not evident.
What is the appropriate next step for the evaluation/management of this patient?