What Does This CT Scan Of Lungs Indicate?

Posted on Sat, 10 Jan 2015

Question: Hi, I had an MRI a year back and 3 small nodules were discovered on my lungs. I'm 43 and a non-smoker. I had a CT scan to confirm this and then had another CT scan 6 months later. After the last scan the radiologist said the nodules were stable since the last scan with largest one being 6mm. He said the nodules have the appearance of scars and there was no instruction for follow-up. My questions are 1. One nodule was 1 mm difference on one side example 4x5mm to 5x5mm, but on inquiring with several people that would just seem to be down to a very slight variation in image or the radiologists interpretation -is this correct? 2. Would you still advise another CT scan in 12 months as per the Fleischner Society Recommendations or not? I’d obviously rather not subject myself to more radiation from the CT scan and would like to forget about this. Thanks in advance for your help!

Answered by Dr. Drkaushal85 (2 hours later)

Brief Answer:
no need to worry much.

Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
And no need to worry as your nodules are benign only, mostly healed scar tissue due to previous lung insult (infection).
And yes, this slight variation (1 mm ) is mostly due to radiologist's interpretation. Not due to disease process. So this confirms that your nodules are benign only as they are static over 6 months.
And according to fleischner society recommendations you are low risk patient.
And according to this first follow up is at 12 months not at 6 months. So I advice you to get done repeat CT THORAX after 12 months and if the nodules are static then no further follow up CT is recommended.
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. Yogesh D

Follow up: Dr. Drkaushal85 (2 hours later)

Thx for you reply.

If they are benign and static after 6 months why another follow-up?

Answered by Dr. Drkaushal85 (21 minutes later)

Brief Answer:
to rule out remote possibility of malignancy.

Detailed Answer:
Hello dear, thanks for your follow up question.
12 month follow up CT is needed to rule out remote possibility of malignant nodule.
If your follow up CT after 12 months is suggestive of same nodules then it is 100% benign and no chance of malignant nodules.
As nodules are static for almost 18 month. So this suggest absence of malignancy and confirms benign nature of nodules.
And no need to worry for radiation exposure as duration is more (almost 18 months). So it will not cause any radiation damage.
Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Drkaushal85 (11 minutes later)

Thx. So another scan 12 months from the original initial scan, or 12 months from the 6 month follow-up scan I more recently had?

Answered by Dr. Drkaushal85 (17 minutes later)

Brief Answer:
12 months from the 6 month follow up.

Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
12 months from six month follow up date.
And 18 months from the first CT scan date.
Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Drkaushal85 (7 minutes later)

Thank you very much. In you experience if the radiologist said they remember scar and didn't give instruction for another follow up do you think I should stop worrying?

Answered by Dr. Drkaushal85 (32 minutes later)

Brief Answer:
yes, you should not worry at all.

Detailed Answer:
Hello dear, thanks for your follow up question.
In my opinion, since your 6 month follow up scan is same, I don't think it is malignancy. It is benign nodules only.
And no need for further scans too. But according to guidelines you should get done repeat ct scan after 12 months.
And no need to worry at all as it is benign only.
I forget to ask you your occupation and work place.
I will be happy to help you further.
Wish you good health.

Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Drkaushal85 (24 minutes later)

I work in HR now. Used to be a chef before that.

Answered by Dr. Drkaushal85 (16 minutes later)

Brief Answer:
Do you have any chemical exposure?

Detailed Answer:
Hello dear,

Thanks for your follow up question.

Do you have any chemical exposure in past or at present. Or do you have any pet at home or dust or pollen exposure.

I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Drkaushal85 (8 hours later)

no exposure to chemicals like industrial things. I've always had pets and dust and pollen does effect me. I also had pneumonia as a baby and I have Asthma.

Answered by Dr. Drkaushal85 (24 minutes later)

Brief Answer:
Is your asthma controlled?

Detailed Answer:
Hello dear, thanks for your follow up question.

So, now things are clear. You have these nodules mostly due to pneumonia in childhood.

So the nodules are benign only. No need to worry for malignancy.

Is your asthma controlled?

I will be happy to help you further.

Wish you good health.

Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Drkaushal85 (14 minutes later)

Yes, my asthma is controlled now, I had it worse as a child. I had a lot of chest infections also. It was mild pneumonia as a child as my mother remembers.

Answered by Dr. Drkaushal85 (23 minutes later)

Brief Answer:
I advise that you to avoid pets.

Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
In my opinion you should avoid pets as animal fur is potent allergen. May this be the factor for uncontrolled asthma.
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. Vinay Bhardwaj

Follow up: Dr. Drkaushal85 (19 minutes later)

One last question - I'm guessing cooking in a kitchen as a profesional chef earlier in my career with the normal fumes, smoke, steam, heat, cleaning products etc wouldn't be an added risk for nodules (otherwise I guess it would be a risky profession)?

by the way, you've been awesome!

Answered by Dr. Drkaushal85 (38 minutes later)

Brief Answer:
for how much duration you work as chef?

Detailed Answer:
Hello dear, thanks for your question on HCM.
Yes, you are right. Fumes, smoke, smeam can affect but only in susceptible individual.
And it will cause bronchitis or asthma more, nodules are less likely.
But the effect is depends on duration of exposure. Short term exposure will not cause any effect.
So let me know the duration of your exposure.
And thanks for the kind words. Its always encouraging. I am truly obliged. Thanks again.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Drkaushal85 (11 minutes later)

I was working as a chef for about 10 years (from 15 to 25). But I guess if it were that harmful thousands of chefs worldwide would have lung cancer or lung issues?

The only concern I guess would be cleaning products (degreasers etc) chemicals to clean the stoves etc where there would be a lot of steam etc in the atmosphere, but again all chefs use these products and for lot longer than I did. And I guess many other professions use industrial cleaning products too.

Sorry, I worry too much about cancer...

Answered by Dr. Drkaushal85 (50 minutes later)

Brief Answer:
only susceptible individuals are affected.

Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
I already wrote that only susceptible individuals are affected. This goes same with smoking. Not all smokers are getting COPD ( Chronic Obstructive Pulmonary Disease ) or lung cancer. Only susceptible individuals are affected.
And yes you are right about detergent fume.
And that occupational exposure to fumes and steam may be the cause for your asthma.
And no need to worry much for cancer. As your nodules are benign only.
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. Vinay Bhardwaj