This is a 62-years old man with a large necrotic left hilar mass with brain, liver, and pleural metastases.
The issue here is not to just diagnose the adenocarcinoma, which this turned out to be, but to also get adequate material for EGFR, ALK, PDL1, ROS1, etc. I could have biopsied the left hilar mass, but I was not confident that given the amount of necrosis, I would get adequate material. The same was the argument for the large liver lesion.

The left pleural nodule was small, but non-necrotic and using an 18G coaxial biopsy gun, I could ensure at least 10-12 good cores that would suffice for all the investigations that this patient would need.