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Central lung cancer with airway obstruction — SCE Respiratory MCQ

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HardLung CancerCentral lung cancer with airway obstructionSCE Respiratory

A 75-year-old woman with suspected lung cancer has CT showing a central left hilar mass causing lobar collapse. She has stridor when lying flat. Oxygen saturation is 93% and there is no distant disease on initial CT. What is the most appropriate investigation?

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Correct answer: E — Urgent bronchoscopy with airway assessment and tissue sampling

A central mass with lobar collapse and positional stridor requires urgent bronchoscopy for airway assessment and tissue diagnosis. Delayed imaging or spirometry-first pathways risk deterioration from airway obstruction. Pleural aspiration is not possible without effusion, and antifibrotics are irrelevant.

Reference: NICE NG122 Lung cancer; BTS bronchoscopy practice standards