Correct!
1. MRI of the brain
Image-guided drainage of the new right pleural effusion is clearly indicated. The development of a new pleural effusion in the context of an unexplained ipsilateral pulmonary nodule, particularly given the tracer accumulation in the pleura at the 18FDG-PET scan (Figure 5), is a potentially worrisome situation, and therefore tissue sampling of the right lung nodule is advisable. As noted previously, tissue sampling by percutaneous transthoracic needle biopsy or surgical biopsy is appropriate; however, there is no indication for brain MRI.
The patient underwent percutaneous transthoracic needle biopsy (Figure 7), which only yielded scant blood, inflammatory cells, fibrotic material, and non-specific findings.
Figure 7. Image acquired during percutaneous transthoracic needle biopsy (A). The right pleural effusion is evident. Imaging immediately following the biopsy procedure shows a right pneumothorax (*, B).
Which of the following represents the most appropriate recommendation for the patient’s management? (Click on the correct answer to be directed to the thirteenth and final page)