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Should I Be Concerned About An Irregular Shaped Pulmonary Opacity Within The Posterior Aspect Of The Right Lower Lobe?

Posted on Sat, 13 Mar 2021

Question: Hello, I am a 50 year old white female (Non-Smoker) average height and weight and had to do a follow-up CT scan due to abnormal opacity within the right lower lobe on prior cardiac screening. The follow-on CT impression found: An irregular shaped pulmonary opacity within the posterior aspect of the right lower lobe. Given differences in technique, this does not appear significantly changed from the prior study. Therefore, an infectious process is considered unlikely. Potentially this could represent an area of chronic scarring though malignancy remains in the differential. This could be followed up with either a PET/CT or a repeat CT scan in 3-6 months. Histologic sampling is an option. Should I be concerned about these findings?

Answered by Dr. Drkaushal85 (34 minutes later)

Brief Answer:
No need to worry much for this findings.

Detailed Answer:

Hi,

Since you are non smoker and your opacity is stable, possibility of lung cancer is very very rare.
Possibility of lung scarring (fibrosis) is more likely.
In my opinion, no need for PET scan.
Get done repeat CT thorax after 6-8 months.
If opacity is stable then no further scans are required.
Please let me know
1. Do you have any respiratory symptoms like cough, chest pain, breathlessness etc?
2. Do you have history of lung infection like tuberculosis or pneumonia in the past?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (24 minutes later)

Thank you for your response and also felt that my risk for lung cancer is low since I have never smoked. To answer your questions:

1. Yes, I do have some respiratory symptoms. Shortness of Breath (exercise intolerance) and very fatigued. I do have some chest heaviness also. Every so often I get a sharp pain just below the right breast but goes away quickly.
2. No, no history of recent lung infections.

I am under a cardiologist care for CAD. My recent CT Calcium score was 348.

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
Get done PFT.

Detailed Answer:

Hi,

Since you have respiratory symptoms, we should definitely rule out bronchitis in your case.
So get done PFT (Pulmonary Function Test).
If PFT is showing obstructive defect then you will need inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Please let me know if you already had PFT done in the past.
And what was your ejeculation fraction (EF) in 2d echo?
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Prasad