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I just went through this. I have had a recurrence in a lymph node in the neck. My doctor recommended a PET scan from my hips up to the top of my head. PET showed two new spots on my lungs that lit up. The one on the left was not very solid as far as the imaging was concerned as was kind of shadowy. The one on the right was 15mm in size but had a ribbon shape instead of the normal nodule shape you would expect. Either way they decided to needle biopsy the one on the right lung. They had some trouble getting three clean samples of tissue and only got one so the official diagnosis was inconclusive (as they like all three to be clean). The good news is that the one clean piece of tissue showed no cancer but some inflammation.
I have has a subsequent CT and the shadows are still there but have not changed. As I am going into additional treatment they said they will watch the lungs over time but will concentrate on that lymph node for treatment.

Hope this helps.