Lung Cancer — RACP Adult Medicine MCQ

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ModerateRespiratoryLung CancerRACP Adult Medicine

A 65-year-old man with a 50-pack-year smoking history presents with haemoptysis. CXR shows a right hilar mass with ipsilateral mediastinal widening and right upper lobe collapse. What is the most likely CXR diagnosis?

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Correct answer: B — Lymphoma

A unilateral hilar mass with mediastinal widening and lobar collapse in a heavy smoker is most consistent with bronchogenic carcinoma (lung cancer) causing endobronchial obstruction. However among the options, lymphoma can also present with mediastinal widening. The clinical context (heavy smoker, haemoptysis, unilateral) favours primary lung cancer. Urgent CT and bronchoscopy are required.

Reference: Cancer Council Australia – 2024 – Lung Cancer Guidelines