Chest X-ray showed a single nodule. Is a biopsy required to rule out cancer?

Hello doctor,

I am a 30-year-old female. The initial illness began early this year. The symptoms were cough, shortness of breath (SOB), chest pain, and wheezing. I was treated for pneumonia but never got better. Repeated X-rays showed adenopathy as a possibility. So, a CT scan was done which showed hilar, mediastinal adenopathy and a single pulmonary nodule of 0.47 inch along with some hypodense lesions on the spleen. A biopsy was done on the lung tissue and on the endobronchial mass but not on the lymph nodes or nodule. There was no fungal, bacterial or viral cause isolated. I have been largely asymptomatic since then with an exception of some chest pain. I went in for a follow-up computed tomography (CT) scan last week. There is still hilar, mediastinal adenopathy and now pre-tracheal aortopulmonary adenopathy along with the nodule. But, the size is the same. The doctor wants a CT scan in four months and thinks this could be the result of a fungal infection but he is not sure. I am wondering if a biopsy of the actual nodes or nodule would be necessary to rule out cancer. I am so concerned and the thought of waiting four months is devastating. I am a former smoker for five years. I take Lexapro, Adderall, and Microgestin.