This is a 57-years old lady, treated in the past for Ca rectum and Ca breast. A surveillance PET showed a mildly active 7.8 x 6.5 mm lung nodule in the posterior basal segment of the left lower lobe with a small nodule more anterior to it. It was new as compared to a scan done in the past.
The question was; is this metastasis from breast or from rectum or something else?

The biopsy was simple using a 20G coaxial biopsy gun. There was no complication. The diagnosis was adenocarcinoma…likely to be a lung primary. So after having had carcinoma breast and then rectum, she landed up with a solitary new primary lung adenocarcinoma.