Situation
A patient has subcarinal lymph node enlargement, and a small peripheral nodule. What would you do ?
The peripheral nodule needs a biopsy to exclude small cell. With a small peripheral nodule and a 1cm subcarinal lymph node some would just resect the peripheral lesion. If the subcarinal lymph node is larger than this you could do a trans carinal biopsy, before proceeding to surgical resection.