Correct!
5. The chest repeat chest radiography shows no change in the interlobular septal thickening, suggesting increased pressure edema is probably not responsible for the chest radiographic findings

Repeat chest radiography shows persistent, extensive, bilateral interlobular septal thickening, relatively unchanged since the presentation chest radiograph and apparently unaffected by the attempts at diuresis in the interval. If the interlobular septal thickening were the result of increased pressure edema, some improvement in the chest radiographic findings would be expected following attempts at volume overload correction. Therefore, the absence of such change suggests a cause other than increased pressure edema for the extensive interlobular septal thickening should be sought. No new or enlarging pleural effusions are present and no new cavitary pulmonary nodules are seen. No evidence of pneumothorax is present.

Which of the following represents the next most appropriate step for the evaluation of this patient? (Click on the correct answer to proceed to the sixth of eight pages)

  1. 18FDG-PET scan
  2. 68Ga-citrate scan
  3. Enhanced thoracic CT
  4. Flexible fiberoptic bronchoscopy with transbronchial biopsy
  5. Percutaneous transthoracic needle biopsy

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