Correct!
2. Comparison to prior chest radiographs
The first course of action when many lesions are discovered at chest imaging is typically to compare the current study to older, prior examinations to assess for stability. While the lesion in the right upper thorax in this patient’s chest radiograph could be aggressive, as shown in Figure 3C, indolent lesions may present quite similarly; in that figure (Figure 3C), the neurogenic neoplasm (a schwannoma) closely resembles the patient’s presentation frontal chest radiographic finding, and many neurogenic neoplasms in adults, particularly schwannomas, are not cause for alarm in most circumstances.
Figure 3. Focused frontal chest radiographs showing (A) The current patient (see Figure 1A); (B) a right subclavian artery pseudoaneurysm in an intravenous drug user; (C) neurogenic neoplasm (schwannoma), and; (D) plasmacytoma.
Should the right apical lesion be stable for several years, the further diagnostic approach would be altered.
An older chest radiographs from 7 years earlier was located for comparison (Figure 4).
Figure 4. The current frontal chest radiograph (A) compared with a prior frontal chest radiograph performed 7 years earlier (B).
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 12 pages)