Correct!
3. Comparison of the thoracic CTs shows serial progression of the cystic and cavitary process
The serial thoracic imaging studies suggest a progressive abnormality characterized initially by small cysts, likely an airway-related process, which subsequently enlarge and develop nodular components, eventually progressing into masses. The thoracic CT confirms the right middle lobe mass (arrows) seen at presentation chest radiography and shows the right suprahilar mass (arrowheads) located within the posterior segment of the right upper lobe. These abnormalities are not waxing and waning / recurrent, or migratory; rather, they are relentlessly progressive. No pleural abnormalities are present, and the marked abnormalities on the thoracic CT studies are not interstitial in nature. No features to suggest fibrotic lung disease- such as architectural distortion, reticulation, traction bronchiectasis, and honeycombing- are evident.
What is the appropriate next step for the evaluation / management of this patient?