A 68-year-old woman is evaluated in follow-up after a 5mm pulmonary nodule was discovered on chest imaging obtained 9 months ago. She feels well and has not had shortness of breath, cough, hemoptysis, weight loss, or chest pain. She has a 50-pack-year smoking history and is a recurrent smoker. Examination revealed normal vital signs, no cervical or supraclavicular lymphadenopathy, and clear lungs to auscultation bilaterally (see report).
Repeated chest CT: Interval increase in the size of the nodule, now measuring 10.5 mm in diameter, and no evidence of mediastinal or hilar lymphadenopathy.
Which of the following is the most appropriate next step?
September 2, 2026 54
