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Somewhat quirky lung case. 65 year old guy big time smoker, mediastinal lesions on CT. Pet showed subcarinal uptake and left hilar uptake. Biopsy positive for NSCLC favoring adenoCA, PDL-1 is 5% all others negative. On the bronch they saw some endoluminal lesions in the right middle lobe and bronchus intermedius. This picture is attached. They brush cytologied this and it also returned as NSCLC. How do you stage this? Is it considered stage IV mets. I was going to plan him see how bad the dvh looks then treat chemo/rt. Also, he had bronchoscope but not an endoscopy, is that necessary? Lesion is ttf-1 positive.