A 71-year-old patient, smoker of 2 packs of cigarettes/day for 50 years, with good quality of life and no other pathologic history of interest, consults for cough and hemoptotic expectoration. Physical examination revealed no significant pathological findings. Chest X-ray showed a mass of 4x3.4 cm lower right, a finding that was confirmed in the thoracoabdominal CT scan, which located the lesion in the lower lobe and found no adenopathy or metastasis. Bronchoscopy showed an infiltrating lesion in the right basal pyramid, biopsied as a well-differentiated squamous cell carcinoma. As for respiratory function tests, the FVC is 3,300 cc (84%) and the FEV 1 is 2,240 cc (80%). What should be the next step to follow in this patient?
1 and 5: These are diagnostic tests, they are meaningless since you have already made the diagnosis. 2: Age should not be a limiting factor, especially considering that it is only 71 years old, but especially because the patient's "quality of life" is good (and I put "quality of life" because it is a term used erroneously, it is supposed to mean that he maintains a good functional level). 3: Presents a very mild respiratory limitation, does not require such a test. 4: Is the correct one.
Perform mediastinoscopy.
Surgical intervention with curative intent should be contraindicated due to the advanced age of the patient.
An oxygen consumption test should be performed, given the respiratory limitation he presents.
Surgical resection (lobectomy of the lower lobe of the right lung) should be indicated directly.
A trantoracic puncture should be performed.
These are diagnostic tests, they are meaningless since you have already made the diagnosis.
Age should not be a limiting factor, especially considering that it is only 71 years old, but especially because the patient's "quality of life" is good (and I put "quality of life" because it is a term used erroneously, it is supposed to mean that he maintains a good functional level).
Presents a very mild respiratory limitation, does not require such a test.
These are diagnostic tests, they are meaningless since you have already made the diagnosis.