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OpenOnco · Diagnostic · Lung cancer suspect · LDCT screening + 3.2 cm RUL mass (NSCLC vs SCLC)
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OpenOnco · Workup Brief · DIAGNOSTIC PHASE
Pre-tumor-board workup brief
DPLAN-PZ-DIAG-LUNG-DX-001-V1 · v1 · 2026-05-12
Patient
PZ-DIAG-LUNG-DX-001 · suspicion lineage: lung_cancer_suspect
Tissues: lung, hilar_lymph_nodes · Hypotheses: DIS-NSCLC, DIS-SCLC, DIS-LUNG-METASTATIC-FROM-OTHER
65M heavy smoker (40 pack-years, current) referred from screening LDCT program — 3.2 cm spiculated mass right upper lobe + 2 enlarged right hilar nodes (largest 1.4 cm). solitary_pulmonary_nodule on initial LDCT actually evolved into mass on diagnostic CT. Subsequent CT chest with contrast: irregular lung_mass with mediastinal LAD level 4R + 7. PET-CT showed FDG-avid primary + LN + small adrenal nodule (1.1 cm, equivocal). No bone uptake. No brain MRI yet. Persistent_cough × 4 months, mild hemoptysis × 2 episodes. Histology pending bronchoscopic biopsy (scheduled). NSCLC vs SCLC vs metastatic carcinoma differential — central location + smoker raises SCLC concern but no paraneoplastic syndromes. Workup at the post-imaging / pre-histology stage where NSCLC-vs-SCLC differentiation matters for Tx pathway selection.

Workup steps (3)

MDT brief

Discussion questions (1, 0 blocking)

  • DQ-DIFFERENTIAL
    What is the differential diagnosis plan between hypotheses: DIS-NSCLC, DIS-SCLC, DIS-LUNG-METASTATIC-FROM-OTHER? Which molecular / IHC tests differentiate them?
    Multiple hypotheses — must be differentiated before treatment discussion.
    → pathologist

MDT talk tree (2 steps)

#OwnerTopicAction
1pathologistPathology confirmation What is the differential diagnosis plan between hypotheses: DIS-NSCLC, DIS-SCLC, DIS-LUNG-METASTATIC-FROM-OTHER? Which molecular / IHC tests differentiate them?
2radiologistSpecialist review Stage / restaging imaging + biopsy guidance — radiologist.

Skills (required) — mandatory virtual specialists (2)

  • Pathologist (general) required
    Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
    Owns: DQ-DIFFERENTIAL
  • Radiologist required
    Stage / restaging imaging + biopsy guidance — radiologist.
Technical MDT skill metadata (2/16 activated in this plan)
All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
Specialistskill_idVersionLast reviewedSign-offsDomain
Cellular therapy specialist (CAR-T)cellular_therapy_specialistv0.1.02026-04-250cellular_therapy
Clinical pharmacistclinical_pharmacistv0.1.02026-04-250clinical_pharmacy
Hematologist / oncohematologisthematologistv0.1.02026-04-250hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)hematopathologistv0.1.02026-04-250hematopathology
Infectious disease / hepatologyinfectious_disease_hepatologyv0.1.02026-04-250infectious_diseases
Medical oncologist (solid-tumor chemotherapist)medical_oncologistv0.1.02026-04-250solid_oncology
Molecular geneticist / molecular oncologistmolecular_geneticistv0.1.02026-04-250molecular_oncology
Palliative carepalliative_carev0.1.02026-04-250palliative_care
Pathologist (general)pathologistv0.1.02026-04-250pathology
Primary care / family physicianprimary_carev0.1.02026-04-250primary_care
Psycho-oncologistpsychologistv0.1.02026-04-250psychosocial
Radiation oncologistradiation_oncologistv0.1.02026-04-250radiation_oncology
Radiologistradiologistv0.1.02026-04-250diagnostic_imaging
Social worker / case managersocial_worker_case_managerv0.1.02026-04-250psychosocial
Surgical oncologistsurgical_oncologistv0.1.02026-04-250surgical_oncology
Transplant specialist (BMT)transplant_specialistv0.1.02026-04-250cellular_therapy
plan_id: DPLAN-PZ-DIAG-LUNG-DX-001-V1 | version: 1 | generated: 2026-05-12T18:41:26.947469+00:00
Per FDA non-device CDS positioning (CHARTER §15): Diagnostic-phase MDT support: structure the workup, identify the team, surface unresolved questions. Not a medical device; not a treatment plan.
Per FDA non-device CDS positioning (CHARTER §15): DIAGNOSTIC PHASE — this output describes diagnostic workup only. Treatment plan generation is blocked until histology is confirmed (CHARTER §15.2 C7). Do not treat on suspicion.
This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.