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What Does This CT Scan Finding Indicate?
Question: I would like your take on my CT scan I had yesterday:
FINDINGS: Lungs and pleura: A focal consolidation is seen in the
posterior segment of the right upper lobe with central
calcification. This consolidation extends beyond the major
fissure into the superior segment of the right lower lobe.
Several adjacent right upper lobe and right lower
lobe calcified nodules are seen. Bilateral lower lobe subpleural
cluster of nodules and tree in bud opacities are seen in the
posterior basal segments of both lower lobes. In addition a
nodular consolidation with a central calcification is seen in the
anterobasal segment of the right lower lobe in subpleural
location. The bronchial tree is patent.
Cardiovascular mediastinum: The ascending aorta has diameter of
30.8 mm. The main pulmonary artery has with of 26 .4 mm. The
descending aorta has a diameter of 22.3 mm. The aortic arch has a
width of 26.6 mm. the aortic root has diameter of 38.8 mm. The
coronary arteries are noncalcified. The cardiac chambers are
normal in size. The pericardium is normal.
Noncardiovascular mediastinum: The structures are normal.
Chest wall, axilla, neck: The structures are normal.
Limited views of the upper abdomen: A nodule is seen in the
region of the right adrenal gland measuring 14.9 mm in diameter
with low attenuation.
Skeletal structures: The structures are normal.
Impression:
1. Multiple bilateral foci of consolidation, nodules and
calcifications as well as bilateral lower lobe tree in bud
opacities most likely indicative of a granulomatous process.
2. The possibility of coccidioidomycosis should be considered.
3. Small right adrenal gland adenoma.
- - - - -
Add'l note from my Primary Care Physician:
They saw an adrenal incidentaloma - these are common, small benign growths see on one or both of the adrenal glands. If they are less than 4 cm (yours is 14 mm) and smooth/round with low attenuation on CT scan, they do not require further work up.
FINDINGS: Lungs and pleura: A focal consolidation is seen in the
posterior segment of the right upper lobe with central
calcification. This consolidation extends beyond the major
fissure into the superior segment of the right lower lobe.
Several adjacent right upper lobe and right lower
lobe calcified nodules are seen. Bilateral lower lobe subpleural
cluster of nodules and tree in bud opacities are seen in the
posterior basal segments of both lower lobes. In addition a
nodular consolidation with a central calcification is seen in the
anterobasal segment of the right lower lobe in subpleural
location. The bronchial tree is patent.
Cardiovascular mediastinum: The ascending aorta has diameter of
30.8 mm. The main pulmonary artery has with of 26 .4 mm. The
descending aorta has a diameter of 22.3 mm. The aortic arch has a
width of 26.6 mm. the aortic root has diameter of 38.8 mm. The
coronary arteries are noncalcified. The cardiac chambers are
normal in size. The pericardium is normal.
Noncardiovascular mediastinum: The structures are normal.
Chest wall, axilla, neck: The structures are normal.
Limited views of the upper abdomen: A nodule is seen in the
region of the right adrenal gland measuring 14.9 mm in diameter
with low attenuation.
Skeletal structures: The structures are normal.
Impression:
1. Multiple bilateral foci of consolidation, nodules and
calcifications as well as bilateral lower lobe tree in bud
opacities most likely indicative of a granulomatous process.
2. The possibility of coccidioidomycosis should be considered.
3. Small right adrenal gland adenoma.
- - - - -
Add'l note from my Primary Care Physician:
They saw an adrenal incidentaloma - these are common, small benign growths see on one or both of the adrenal glands. If they are less than 4 cm (yours is 14 mm) and smooth/round with low attenuation on CT scan, they do not require further work up.
Brief Answer:
You should definitely get done bronchoscopy.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the CT report you have mentioned.
This report is suggestive of granulomatous infection like tuberculosis more.
So better to consult pulmonologist and get done bronchoscopy and XXXXXXX (bronchoalveolar lavage) analysis to confirm the diagnosis. XXXXXXX is very informative in isolating causative organism.
And in your case XXXXXXX is must.
So consult pulmonologist and discuss all these.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
You should definitely get done bronchoscopy.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the CT report you have mentioned.
This report is suggestive of granulomatous infection like tuberculosis more.
So better to consult pulmonologist and get done bronchoscopy and XXXXXXX (bronchoalveolar lavage) analysis to confirm the diagnosis. XXXXXXX is very informative in isolating causative organism.
And in your case XXXXXXX is must.
So consult pulmonologist and discuss all these.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr
Should I be very worried? Have you seen something like this before? Could I still have the infection? Is this something curable?
No cancer, correct?
Also,
Is bronchoscopy fairly safe? I am nervous. Is the finding suggestive of lung fibrosis? I have no symptoms other than some air hunger, which I am not sure if that is due to anxiety. I can still exercise with no issue.
Should I be very worried? Have you seen something like this before? Could I still have the infection? Is this something curable?
No cancer, correct?
Also,
Is bronchoscopy fairly safe? I am nervous. Is the finding suggestive of lung fibrosis? I have no symptoms other than some air hunger, which I am not sure if that is due to anxiety. I can still exercise with no issue.
Brief Answer:
No this is not lung cancer.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
First of all no need to worry for lung cancer or lung fibrosis.
You are not having any of these diseases.
And yes, bronchoscopy is very safe procedure.
It is day care procedure. It is only 15-20 minutes procedure.
So don't afraid of it. Get it done for better and faster improvement.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
No this is not lung cancer.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
First of all no need to worry for lung cancer or lung fibrosis.
You are not having any of these diseases.
And yes, bronchoscopy is very safe procedure.
It is day care procedure. It is only 15-20 minutes procedure.
So don't afraid of it. Get it done for better and faster improvement.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is it possible to still have an active infection? Should I also run blood tests for TB and Valley Fever? I assume if they find out the cause I can take antibiotics.
Is this severe lung damage or will my lungs eventually heal up?
Also, about how long ago would you estimate I got an infection? I assume due to calcification it must have been a while ago? Or, could this be fairly new? I have not had any major respiratory issues for at least two years so this perplexes me.
Is this severe lung damage or will my lungs eventually heal up?
Also, about how long ago would you estimate I got an infection? I assume due to calcification it must have been a while ago? Or, could this be fairly new? I have not had any major respiratory issues for at least two years so this perplexes me.
Brief Answer:
Tree in bud appearance suggest fresh infection.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, you are right. Calcification suggests old healed infection.
But tree in bud appearance suggests fresh, active infection.
1 can not specifically tell the duration.
Blood test for tuberculosis is not very specific. And tuberculosis treatment is long. So better to be sure before starting this long treatment.
Bronchoscopy will help you in solving all these problems. So consult pulmonologist and discuss all these.
And don't worry, with proper treatment, your lung infection will definitely heal.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.
Tree in bud appearance suggest fresh infection.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, you are right. Calcification suggests old healed infection.
But tree in bud appearance suggests fresh, active infection.
1 can not specifically tell the duration.
Blood test for tuberculosis is not very specific. And tuberculosis treatment is long. So better to be sure before starting this long treatment.
Bronchoscopy will help you in solving all these problems. So consult pulmonologist and discuss all these.
And don't worry, with proper treatment, your lung infection will definitely heal.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is there a chance it could be sarcoidosis?
Brief Answer:
Tissue diagnosis is must for sarcoidosis.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Sarcoidosis is tissue diagnosis. And for tissue, again bronchoscopy is must.
Other supportive evidence for sarcoidosis are
1. Elevated Serum calcium
2. Serum ACE Level
3. Serum ANA titer etc.
Please let me know if you have undergone these tests or not.
Tissue diagnosis is must for sarcoidosis.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Sarcoidosis is tissue diagnosis. And for tissue, again bronchoscopy is must.
Other supportive evidence for sarcoidosis are
1. Elevated Serum calcium
2. Serum ACE Level
3. Serum ANA titer etc.
Please let me know if you have undergone these tests or not.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No I have not. My routine blood work came back normal. Regular calcium levels fine. I assume I would have more symptoms?
Also, chances of malignancy are fairly low? Should I see my doctor again today to find out if I need to stay away from my kids? Worried they may get something.
Also, chances of malignancy are fairly low? Should I see my doctor again today to find out if I need to stay away from my kids? Worried they may get something.
Brief Answer:
Yes, these infections are contagious.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Chances of malignancy (cancer) are very very less.
And yes, these kind of infections are contagious.
So better to wear face mask all the time you are at home.
And yes, consult your doctor an discuss things I can have told you like bronchoscopy and all.
You need two diagnose yourself as early as possible so that appropriate treatment can be started.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Yes, these infections are contagious.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Chances of malignancy (cancer) are very very less.
And yes, these kind of infections are contagious.
So better to wear face mask all the time you are at home.
And yes, consult your doctor an discuss things I can have told you like bronchoscopy and all.
You need two diagnose yourself as early as possible so that appropriate treatment can be started.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
How long does it take for tree in bud to appear? By that, I mean this is a fairly new development in my lungs? Does it make sense that I am assymptomatic? Does this mean I have a weakened immune system or maybe my body is fighting this infection? Can it go away on its own?
Brief Answer:
Tree in bud appearance suggests active infection.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Answer to your 1st question.
There is no exact time for development of tree in bud appearance. But it usually takes 2-3 weeks roughly.
Answer to your 2nd question.
Yes, this is mostly new development in lungs.
Answer to your 3rd question.
Yes, this can be seen in asymptomatic patient. But initial common symptoms are weight loss, low grade fever, decreased appetite etc.
Do you have any of these symptoms?
Answer to your 4th question.
It is not 100% true but yes, this kind of infections are commonly seen in patients with low immunity.
Answer to your 5th question.
I don't think it will go by its own. You will have to start treatment.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Tree in bud appearance suggests active infection.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Answer to your 1st question.
There is no exact time for development of tree in bud appearance. But it usually takes 2-3 weeks roughly.
Answer to your 2nd question.
Yes, this is mostly new development in lungs.
Answer to your 3rd question.
Yes, this can be seen in asymptomatic patient. But initial common symptoms are weight loss, low grade fever, decreased appetite etc.
Do you have any of these symptoms?
Answer to your 4th question.
It is not 100% true but yes, this kind of infections are commonly seen in patients with low immunity.
Answer to your 5th question.
I don't think it will go by its own. You will have to start treatment.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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