system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 68-year-old man presents to his primary care physician for fatigue. He is accompanied by his granddaughter who is worried that the patient is depressed. She states that over the past 2 months he has lost 15 lbs. He has not come to some family events because he complains of being “too tired.” The patient states that he tries to keep up with things he likes to do like biking and bowling with his friends but just tires too easily. He does not feel like he has trouble sleeping. He does agree that he has lost weight due to a decreased appetite. The patient has coronary artery disease and osteoarthritis. He has not been to a doctor in “years” and takes no medications, except acetaminophen as needed. Physical examination is notable for hepatomegaly. Routine labs are obtained, as shown below:

Leukocyte count: 11,000/mm^3
Hemoglobin: 9 g/dL
Platelet count: 300,000/mm^3
Mean corpuscular volume (MCV): 75 µm^3
Serum iron: 35 mcg/dL

An abdominal ultrasound reveals multiple, hypoechoic liver lesions. Computed tomography of the abdomen confirms multiple, centrally-located, hypoattenuated lesions. Which of the following is the next best step in management?
assistant
Colonoscopy