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Lung Nodule — RACP Adult Medicine MCQ

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ModerateRespiratoryLung NoduleRACP Adult Medicine

A 62-year-old man with a 45-pack-year smoking history undergoes a low-dose CT chest as part of a lung cancer screening programme. A 12 mm part-solid nodule is identified in the right upper lobe. What is the most appropriate next step?

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Correct answer: B — PET-CT scan

For solid or part-solid nodules >8 mm, further characterisation with PET-CT is recommended to assess metabolic activity. Part-solid nodules carry a higher risk of malignancy than pure ground-glass nodules. PET-CT can guide the need for biopsy or surgical resection. The Fleischner Society and Australian Lung Cancer Screening guidelines recommend PET-CT for nodules with high suspicion of malignancy.

Reference: Cancer Council Australia – 2020 – Optimal Care Pathway for Lung Cancer; Fleischner Society – 2017 – Pulmonary Nodule Guidelines