Correct!
1. Bronchogenic malignancy
2. Coccidioidomycosis
4. Post-transplant lymphoproliferative disorder
5.More than one of the above
Given the patient’s cardiac transplantation and immunosuppression, malignancy- both bronchogenic malignancy and post-transplant lymphoproliferative disorder- is a consideration when a new nodule is encountered at chest radiography. Clearly infectious etiologies for a new nodule, including fungal infections, are considerations as well, even given that the patient is on chronic anti-fungal therapy. Among the differential diagnostic considerations listed, hamartoma is unlikely to account for the new nodule as such lesions grow slowly, and the nodule would probably be visible on the chest radiograph performed one year earlier.
Which of the following represents an appropriate next step for the patient’s management? (Click on the correct answer to be directed to the fifth of nine pages).