This is a 60 y/o woman with a 50-pack-year Hx of smoking who presented with a RUL mass. Her History is remarkable for +TB in 2003: she had a clear exposure with a small RUL infiltrate and +AFB. Her isolate was quite pan-SS and she received standard Tx (initially INH/RIF/ETH/PZA) with DOT. She was smear-negative at the end.
She is now assymptomatic but has a suspicious enlarging RUL mass. No other relevant history.
Good (almost normal) PFTs.
Bronch was AFB-smear negative and non-diagnostic.
PET scan showed increased activity (SUV~2.5) in the mass only.
What would you do next?
Answers and further discussion on the post
above.
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I would ask the surgeons to take it out.
That lesion is lung cancer until proven otherwise.
Seems pretty straightforward - take it out. solit mass that is growing and pet positive and she has good lung function.
I'll make it 3 for 3 with resecting it. We have to presume that the pan-sensative TB was appropriately treated, and that this is unlikely to to be a failure of that treatment.
Hey Doug..Hope you become a regular here!
Doug, welcome. Come back and visit the blog more often.
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