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What Do Calcified Granulomas On A Chest X Ray Indicate?
Question: I was recently given a CT scan following a chest xray that showed calcified granulomas. The results show:
Left lower lobe calcified granulomas with left hilar and mediastinal calcified lymph nodes with no pleural effusion.
I also have been having shortness of breath occasionally (more often at night) for the last ten months, although it has been getting better. They started last XXXXXXX following a long period of travel to XXXXXXX I have started having knee pain in both knees which I have never had before, and also have numbness in my ring and pinky finger on one hand (for about the last three months).
I traveled to XXXXXXX CA for 8 years working in the oil fields and am now wondering if these could all be related symptoms of valley fever.
Left lower lobe calcified granulomas with left hilar and mediastinal calcified lymph nodes with no pleural effusion.
I also have been having shortness of breath occasionally (more often at night) for the last ten months, although it has been getting better. They started last XXXXXXX following a long period of travel to XXXXXXX I have started having knee pain in both knees which I have never had before, and also have numbness in my ring and pinky finger on one hand (for about the last three months).
I traveled to XXXXXXX CA for 8 years working in the oil fields and am now wondering if these could all be related symptoms of valley fever.
Brief Answer:
Symptoms suggestive of histoplamosis or sarcoidosis, further inv required
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
Valley fever can be a possibility since you have recently been to California where the disease is endemic.Shortness of breath and knee pain can be explained by valley fever.
However, presence of calcified granulomas, hilar and mediastinal calcified lymph nodes and absence of fever do not favor valley fever.
Calcified lung granulomas or nodules on chest CT scan are associated with tuberculosis, sarcoidosis, histoplasmosis, pneumoconiosis to name a few common causes.
Tuberculosis is not common in your part of world so this possibility can be ruled out.
Other possibilities include sarcoidosis and histoplasmosis.
Pnemoconiosis is an occupational lung disease caused by exposure to industrial dusts like coal dust, silica, etc.
Your symptoms need to be investigated further to find the cause of calcified granulomas.
Histoplasmosis is a very close possibility however clinical assessment is required to look for other evidence of histoplasmosis since it can cause lymphadenopathy and hepatosplenomegaly.
Serological tests are required to confirm the disease.
Sarcoidosis is a disease of exclusion and it can be diagnosed after ruling out other possibilities, detection of serum ACE levels and elevated levels of calcium in urine.
The knee pain and numbness felt on fingers seem to be unassociated with the lung symptoms.
I suggest you to consult a pulmonologist for complete clinical assessment and relevant investigations to diagnose the condition and thus management.
If you have more queries, I will be glad to answer.
Thanks
Dr Shailja Puri
.
Symptoms suggestive of histoplamosis or sarcoidosis, further inv required
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
Valley fever can be a possibility since you have recently been to California where the disease is endemic.Shortness of breath and knee pain can be explained by valley fever.
However, presence of calcified granulomas, hilar and mediastinal calcified lymph nodes and absence of fever do not favor valley fever.
Calcified lung granulomas or nodules on chest CT scan are associated with tuberculosis, sarcoidosis, histoplasmosis, pneumoconiosis to name a few common causes.
Tuberculosis is not common in your part of world so this possibility can be ruled out.
Other possibilities include sarcoidosis and histoplasmosis.
Pnemoconiosis is an occupational lung disease caused by exposure to industrial dusts like coal dust, silica, etc.
Your symptoms need to be investigated further to find the cause of calcified granulomas.
Histoplasmosis is a very close possibility however clinical assessment is required to look for other evidence of histoplasmosis since it can cause lymphadenopathy and hepatosplenomegaly.
Serological tests are required to confirm the disease.
Sarcoidosis is a disease of exclusion and it can be diagnosed after ruling out other possibilities, detection of serum ACE levels and elevated levels of calcium in urine.
The knee pain and numbness felt on fingers seem to be unassociated with the lung symptoms.
I suggest you to consult a pulmonologist for complete clinical assessment and relevant investigations to diagnose the condition and thus management.
If you have more queries, I will be glad to answer.
Thanks
Dr Shailja Puri
.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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