Situation

A patient with previous squamous carcinoma of the ear presents with a small nodule on the CXR in the RLL. Bronchoscopy reveals inflamed mucosa of  the LUL and LLL. Cytology reveals dysplastic cells query malignant. What would you do ?

Opinion

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Opinion

Cytology just reveals a field change so just watch. Advise the patient to stop smoking, as this is causing the field change and they obviously have an unstable bronchial mucosa. A previous head and neck squamous carcinoma mean that the pulmonary nodule is more likely to be a new pulmonary primary than a head and neck secondary.

So evaluate the nodule in the standard manner.