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Clinical Stem 3
A patient with right upper lobe adenocarcinoma progressing on biomarker-directed therapy

Case Description
A 62 year-old Asian male with a 20 pack-year smoking history presented to his primary care physician with persistent cough for 6 weeks. The chest radiograph showed a right upper lobe mass confirmed by chest computed tomography. There was no mediastinal lymphadenopathy. His FEV1 was 36% of predicted. DLCO was 28% of predicted. Results from bronchoscopy with fluoroscopy-guided transbronchial lung biopsy showed poorly differentiated adenocarcinoma. Material was insufficient for molecular analysis due to the large number of immunostains performed in the pathology laboratory. The patient is discussed at your institution's multidisciplinary lung cancer conference.