Correct!
4. a or b
Because the superior segmental right lower lobe lesion is relatively central in location and clearly associated with an airway, bronchoscopy with transbronchial biopsy would be an appropriate technique to employ to obtain a tissue diagnosis. Similarly, the lesion is readily approachable using transthoracic fine needle biopsy, using both aspiration and core biopsy techniques. While thoracotomy certain could obtain a definitive diagnosis for this patient, such an approach is needlessly invasive and expensive and should be employed when other less invasive approaches have failed to obtain a definitive diagnosis.).
Further clinical course. The patient underwent bronchoscopy with transbronchial biopsy, but material sufficient for confident diagnosis could not be obtained. Subsequently, the patient then underwent transthoracic fine needle biopsy using both aspiration and core biopsy techniques, which yielded tissue showing two epithelial cell populations: one consisting of pale round interstitial cells of a respiratory epithelial phenotype, and another consisting of surface cuboidal cells derived from Clara cells. These cell populations were embedded in a sclerotic stroma. The histologic features were considered diagnostic of pulmonary sclerosing hemangioma.
Diagnosis: Pulmonary sclerosing hemangioma
References