Transplant Evaluation Lung Nodule and Medisatinal Lymph-Nodes

1. CT Guided Biopsy + PET CT for staging. Question candidacy in general.

2. Obtain Old CT Scans

2.1. No growth 2 years, end of work-up studies

2.2. Unknown Duration

2.2.1. Solid <8mm

2.2.1.1. Early for Transplant: ACCP Guidelines

2.2.1.2. Urgent Transplant: Proceed with transplant if normal sized mediastinal lymph nodes

2.2.2. Solid >8mm

2.2.2.1. PET CT

2.2.2.1.1. Positive ( SUV >2.5)

2.2.2.1.2. Negative

2.2.3. Semisolid

2.2.3.1. Urgent transplant: EBUS for N2 LN. Must not have pleural disease or other worrisome features.

2.2.3.2. Early for Transplant: CT guided biopsy versus ACCP Guidelines for follow-up. May need N2 biopsy closer to transplant.

2.3. Growth