Robert W. Viggiano, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 68 year old woman was seen for increased back pain in April 2012. In 2000 she had a right lower lobe lung resection for low grade adenocarcinoma, bronchoalveolar type, nonmucinous. Her mass was 2.6 cm in maximal dimension extending to but not invading the pleura. There were clear surgical margins but involvement of one bronchial node. Multiple mediastinal nodes were negative. She had back pain for many years and yearly CTs were negative for metastatic disease.
PMH, SH, FH
Other than the above there was no significant past medical history, social history or family history.
Medications
Physical Examination
There was tenderness to palpation over the mid-thoracic spine and evidence of a previous thoracotomy.
Laboratory
Her complete blood count (CBC), urinanalysis, liver function tests, and calcium were all within normal limits.
Radiology
An x-ray of the chest is interpreted as unchanged from previous x-rays.
At this point which of the following radiologic testing is not indicated? (click on correct answer to move to next panel)
Reference as: Viggiano RW. December 2013 pulmonary case of the month: natural progression. Southwest J Pulm Crit Care. 2013;7(6):318-27. doi: http://dx.doi.org/10.13175/swjpcc155-13 PDF