Transplant Evaluation Lung Nodule and Medisatinal Lymph-Nodes

1. Obtain Old CT Scans

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

1.2. Unknown Duration

1.2.1. Solid <8mm

1.2.1.1. Early for Transplant: ACCP Guidelines

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

1.2.2. Solid >8mm

1.2.2.1. PET CT

1.2.2.1.1. Positive ( SUV >2.5)

1.2.2.1.2. Negative

1.2.3. Semisolid

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

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

1.3. Growth

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