Correct!
5. Video-assisted thorascopic biopsy
As of yet a diagnosis has not been made. It is not likely that a repeat cocci serology or repeat CT scan in 3 months will be particularly helpful. Repeat needle biopsies when the fist biopsy showed adequate tissue is unlikely to be revealing the diagnosis. Bronchoscopy is a possibility but for peripheral lesions needle biopsy usually has a higher diagnostic yield. Therefore, the best answer is a video-assisted thorascopic (VATS) biopsy.
The surgical pathology is shown in figures 3-5.
Figure 3. H&E stains of low power view of wedge resection of lung nodules (Panels A-C) and in situ hybridization for Epstein-Barr virus (EBV) RNS (Panel D).
Figure 4. High power view H&E stains of lung nodules.
Figure 5. Special stains for CD3 (Panel A, T lymphocytes), CD 20 (Panel B, B lymphocytes), CD 15 (Panel C, neutrophils) and CD 30 (Panel D, activated T and B cells).
What is the pathologic diagnosis?