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What Does This Chest X-ray Report Indicate?
Question: I would like your take on a chest X-ray I received yesterday. 44 year old female, non-smoker (quit after 6 years back in 2003). Mother passed away from 7 year battle with lung cancer when she turned 70.
Here are my chest x-ray Radiology readings:
Impression:
1. Query possible 11 mm nodular density which could represent a pulmonary
nodule versus scarring projecting over the peripheral
aspect of the right lower lung on the frontal view, not seen
on lateral view. Suggest further investigation with chest CT.
Also questionable 4.5 x 2.8 cm subtle opacity projecting over the
right apex (potentially confluence of shadows and not well-seen
on the lateral view); this can also be assessed further at chest
CT.
2. Otherwise clear and well-expanded lungs with sharp
costophrenic sulci.
3. Normal cardiomediastinal silhouette and normal hilar regions.
4. No suspicious lytic or sclerotic lesions of bone.
Here are my chest x-ray Radiology readings:
Impression:
1. Query possible 11 mm nodular density which could represent a pulmonary
nodule versus scarring projecting over the peripheral
aspect of the right lower lung on the frontal view, not seen
on lateral view. Suggest further investigation with chest CT.
Also questionable 4.5 x 2.8 cm subtle opacity projecting over the
right apex (potentially confluence of shadows and not well-seen
on the lateral view); this can also be assessed further at chest
CT.
2. Otherwise clear and well-expanded lungs with sharp
costophrenic sulci.
3. Normal cardiomediastinal silhouette and normal hilar regions.
4. No suspicious lytic or sclerotic lesions of bone.
Brief Answer:
The first nodule would need evaluation
Detailed Answer:
Hi
Thanks for your query.
First of all, I would like to know why this x-ray was done, for screening, or for evaluation of some symptoms?
Even if it was for routine screening, the 11 mm nodule is suspicious and would need CT scan to understand better. At this point, it could be anything ranging from scar of previous infection, to benign tumor and even malignancy.
The other subtle opacity is probably nothing, just an artefact.
So I would like to recommend a CT scan of thorax to proceed further.
Hope this helps.
Regards
The first nodule would need evaluation
Detailed Answer:
Hi
Thanks for your query.
First of all, I would like to know why this x-ray was done, for screening, or for evaluation of some symptoms?
Even if it was for routine screening, the 11 mm nodule is suspicious and would need CT scan to understand better. At this point, it could be anything ranging from scar of previous infection, to benign tumor and even malignancy.
The other subtle opacity is probably nothing, just an artefact.
So I would like to recommend a CT scan of thorax to proceed further.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you. I found a bit more detail on the nodule. It was small and smooth and round and it was not seen on the lateral view.
I went in for a chest X-ray because my left rib was hurting. Then this was discovered. No coughing, not short of breath or anything. My last chest X-ray in early 2014 was clear.
Does it help a bit that the nodule was round and smooth?
I get a ct scan done this Monday.
I went in for a chest X-ray because my left rib was hurting. Then this was discovered. No coughing, not short of breath or anything. My last chest X-ray in early 2014 was clear.
Does it help a bit that the nodule was round and smooth?
I get a ct scan done this Monday.
Brief Answer:
Then more in favor of benign nodule
Detailed Answer:
Smooth and round is more in favor of benign but still very difficult to interpret on xray
Then more in favor of benign nodule
Detailed Answer:
Smooth and round is more in favor of benign but still very difficult to interpret on xray
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thank you. Is it true that a potential nodule my size (if there) and given the location of it, my risk should be fairly low? Most nodules are benign?
Brief Answer:
Yes possibility of malignancy fairly low
Detailed Answer:
these type of nodules are often benign but still we should have a high index of suspicion, otherwise we will miss early cancers.
Yes possibility of malignancy fairly low
Detailed Answer:
these type of nodules are often benign but still we should have a high index of suspicion, otherwise we will miss early cancers.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr.,
This is the impression from my CT Scan. My doctor is referring me to a pulmonologist, but told me there is no sign of lung cancer, which is good. I do have some air hunger (it comes and goes). Maybe this explains this? I assume this is curable?
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.
This is the impression from my CT Scan. My doctor is referring me to a pulmonologist, but told me there is no sign of lung cancer, which is good. I do have some air hunger (it comes and goes). Maybe this explains this? I assume this is curable?
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.
Brief Answer:
Suggestive of infection
Detailed Answer:
Hi
This CT scan is suggestive of a granulomatous infection, commonly seen in fungal or tuberculous infections.
There is no evidence of cancer. This can explain your air hunger. Most probably the pulmonologist will do a bronchoscopy to get samples from the lungs and test them for the actual cause. Treatment is available.
Regards
Suggestive of infection
Detailed Answer:
Hi
This CT scan is suggestive of a granulomatous infection, commonly seen in fungal or tuberculous infections.
There is no evidence of cancer. This can explain your air hunger. Most probably the pulmonologist will do a bronchoscopy to get samples from the lungs and test them for the actual cause. Treatment is available.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dr
Great news on cancer piece. Due you think this is suggestive of an old infection? They want to test me for Valley Fever. I have spent a lot of time out West (live in CA), central and South XXXXXXX the Middle East and Central Asia.
Is there a good prognosis for something like this? Does the impression suggest that I have a lot of damage to my lungs?
One more thing--I am experiencing a stuffy nose, a little coughing (from phlegm) and sneezing. I took an allergy pill. Should I be concerned about this? Or could I just have allergies on top of this infection?
Is my infection contagious? I have kids in the house and am worried.
Thank you and thank you for clearing up the old versus new infection question.
Great news on cancer piece. Due you think this is suggestive of an old infection? They want to test me for Valley Fever. I have spent a lot of time out West (live in CA), central and South XXXXXXX the Middle East and Central Asia.
Is there a good prognosis for something like this? Does the impression suggest that I have a lot of damage to my lungs?
One more thing--I am experiencing a stuffy nose, a little coughing (from phlegm) and sneezing. I took an allergy pill. Should I be concerned about this? Or could I just have allergies on top of this infection?
Is my infection contagious? I have kids in the house and am worried.
Thank you and thank you for clearing up the old versus new infection question.
Brief Answer:
Difficult to say for how long this is present
Detailed Answer:
what we can say is that it is still active. Some damage has definitely been done to the lungs but nothing that can't be treated.
It is a good idea to test for valley fever also. But as you have spent time in Asia, tuberculosis should definitely be ruled out.
Stuffy nose may be an upper respiratory infection on top of this. Some of the infections which are possible in you are definitely contagious, so children should not come in contact, if possible.
Difficult to say for how long this is present
Detailed Answer:
what we can say is that it is still active. Some damage has definitely been done to the lungs but nothing that can't be treated.
It is a good idea to test for valley fever also. But as you have spent time in Asia, tuberculosis should definitely be ruled out.
Stuffy nose may be an upper respiratory infection on top of this. Some of the infections which are possible in you are definitely contagious, so children should not come in contact, if possible.
Above answer was peer-reviewed by :
Dr. Yogesh D
Sorry Dr another question--could I have aspergillosis? I don't think my ct scan is indicative of that but thought I would ask.
I retired from the Army and have had numerous TB tests. My mother carried the infection (she was born and raised in Korea) but it was never active.
What my lungs show is that something is active, right? More so than just bronchitis? Is it good that I am not showing many symptoms other than an occasional cough and some air hunger? I am able to take in full breaths--crave doing so often.
I have to wait a few days to see a pulmonologist but worried about the kids--
I retired from the Army and have had numerous TB tests. My mother carried the infection (she was born and raised in Korea) but it was never active.
What my lungs show is that something is active, right? More so than just bronchitis? Is it good that I am not showing many symptoms other than an occasional cough and some air hunger? I am able to take in full breaths--crave doing so often.
I have to wait a few days to see a pulmonologist but worried about the kids--
Brief Answer:
unlikely to be aspergillus
Detailed Answer:
This does not read like aspergillosis. It is definitely more than bronchitis. It is good that there are not many symptoms but diagnosis should not be delayed any further.
unlikely to be aspergillus
Detailed Answer:
This does not read like aspergillosis. It is definitely more than bronchitis. It is good that there are not many symptoms but diagnosis should not be delayed any further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr
I just took blood tests for TB and Valley Fever, along with a sputnam test for TB as well. Pulmonologist asked for those tests to be done first.
Upon those results, I hope to meet with pulmonologist next week. I know I don't want to delay any treatment. Again, fungal infections are treatable?
I just took blood tests for TB and Valley Fever, along with a sputnam test for TB as well. Pulmonologist asked for those tests to be done first.
Upon those results, I hope to meet with pulmonologist next week. I know I don't want to delay any treatment. Again, fungal infections are treatable?
Brief Answer:
Yes fungal infections are treatable
Detailed Answer:
yes, this plan seems fine. Hopefully pulmonologist can clinch the diagnosis
Yes fungal infections are treatable
Detailed Answer:
yes, this plan seems fine. Hopefully pulmonologist can clinch the diagnosis
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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