This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
A 60 yr old man is suspected of having bronchogenic ca; TB has been ruled out in this pt. What should be the next investigation : 
Select and explain. 
A. CT guided FNAC, B. Bronchoscopy and biopsy, C. Sputum cytology, D. X-Ray chest.
B: Bronchoscopy and biopsy
Answer: B: Bronchoscopy and biopsy 
Explanation: Answer is B (Bronchoscopy and biopsy): This patient represents a case of suspected bronchogenic carcinoma. Fibreoptic bronchoscopy and biopsy is the investigation of choice as it allows direct visualization of the tumor mass and provides a means of obtaining tumor tissue for histological diagnosis. HRCT is the alternate investigation but should be done if no specific diagnosis is suggested on bronchoscopy.