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Incidental pulmonary nodule — SCE Respiratory MCQ

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ModerateLung CancerIncidental pulmonary noduleSCE Respiratory

A 74-year-old man has a new 9 mm solid pulmonary nodule on CT performed for renal colic. He smoked 45 pack-years and has upper-lobe emphysema. Previous imaging 5 years ago was normal. What is the most appropriate investigation?

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Correct answer: E — Risk prediction followed by PET-CT or interval CT according to calculated malignancy risk

Solid pulmonary nodules should be managed using validated malignancy risk assessment with PET-CT or surveillance depending on risk. Pneumonectomy is disproportionate before diagnosis and staging. Ignoring the nodule, empirical TB treatment and serum markers are not guideline-based management for an incidental solid nodule.

Reference: BTS Pulmonary Nodule Guideline; NICE NG122