3.4 cm well-circumscribed mass in the basal left lower lobe is not typical of a primary lung tumour. No thoracic lymphadenopathy. Several further subcentimetre pulmonary nodules elsewhere consistent with metastases.
A 6 cm x 4 cm left posterior 5th rib metastasis destroys the adjacent left T5 pedicle and transverse process. This narrows the left T4/5 and T5/6 neural exit foramen but no central spinal cord compression. Further T11 vertebral body metastasis.