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What Does This Lung CT Scan Report Indicate?
Question: Hello.
A pulmonologist had me have a lung CT last week for an ongoing cough to R/O interstitial disease secondary to methotrexate (for psoriasis). Findings were ascending aortic ectasia (3.6cm x 3.3cm), and 3 non-malignant non calcified nodules left lower lobe (2 x 0.3cm, 1 x 0.5cm), plus scarring left lower lobe that looked chronic. The radiologist recommended repeating the CT in either 6 or 12 months due to the aortic issue.
I am a fit, physically active 58-year old female with no hx of HTN, or any CVD. I do have mild asthma. I have a ten year 1PPD smoking history, but quit 30 years ago.
Having just read the report at the online site, I am concerned that I could have or be developing an aortic aneurism--this is my question. I do not return to my doctor for two weeks, and do not want to say anything to my husband about the report until I can say something sensible, but I am concerned. Should I be?
I do not know of any family hx of this, however. I just had an echo and treadmill test and both were negative. My BP usually runs low, can be erratic, though never runs high. Thank you, XXXX
A pulmonologist had me have a lung CT last week for an ongoing cough to R/O interstitial disease secondary to methotrexate (for psoriasis). Findings were ascending aortic ectasia (3.6cm x 3.3cm), and 3 non-malignant non calcified nodules left lower lobe (2 x 0.3cm, 1 x 0.5cm), plus scarring left lower lobe that looked chronic. The radiologist recommended repeating the CT in either 6 or 12 months due to the aortic issue.
I am a fit, physically active 58-year old female with no hx of HTN, or any CVD. I do have mild asthma. I have a ten year 1PPD smoking history, but quit 30 years ago.
Having just read the report at the online site, I am concerned that I could have or be developing an aortic aneurism--this is my question. I do not return to my doctor for two weeks, and do not want to say anything to my husband about the report until I can say something sensible, but I am concerned. Should I be?
I do not know of any family hx of this, however. I just had an echo and treadmill test and both were negative. My BP usually runs low, can be erratic, though never runs high. Thank you, XXXX
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that ascending aortic ectasia may involve each of these structures:
1) Ascending aorta leading to an aneurysm
2) Dilatation of the sinuses of Valsalva
3) Dilatation of the aortic annulus.
I don't know which is the exact conclusion about the ascending aorta (if all the above components are involved), nevertheless I would explain that, as far as there isn't any important aortic regurgitation (it seems to be so, as your cardiac ultrasound was normal), and any evidences of aortic wall dissection, you don't actually have to panic.
3.6x3.3 doesn't seem to express an alarming condition.
The two most important key points to follow in your condition are:
1) A carefully scheduled follow up of aortic diameter progression, as a growth rate of >0.5 cm/y when ascending aorta is 5 cm in diameter (even when asymptomatic), or >4.5 cm (if you are diagnosed with any fibrillopathies such as Marfan, or Ehlers Danlos, etc.), or if the signs of aortic dissection appear, are clear indications for urgent surgery.
2) A close monitoring of blood pressure, to prevent potentially increased high values, in conjunction with a thorough investigation, to identify possible causes of aortic dilation (connective tissue disease, possible infection, systemic disease, etc.).
Meanwhile I would strongly agree with your radiologist, that you should be alert and follow up periodically your aortic diameter.
You should also talk to your husband, and explain to him that for the moment the situation is not problematic, but a careful supervision is needed in the future.
If no progression is seen with the time, there is no need to intervene.
Hope to have fulfilled your answer expectation!
I am at your disposal; whenever you need to ask further questions (you can also ask direct questions).
Best wishes,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that ascending aortic ectasia may involve each of these structures:
1) Ascending aorta leading to an aneurysm
2) Dilatation of the sinuses of Valsalva
3) Dilatation of the aortic annulus.
I don't know which is the exact conclusion about the ascending aorta (if all the above components are involved), nevertheless I would explain that, as far as there isn't any important aortic regurgitation (it seems to be so, as your cardiac ultrasound was normal), and any evidences of aortic wall dissection, you don't actually have to panic.
3.6x3.3 doesn't seem to express an alarming condition.
The two most important key points to follow in your condition are:
1) A carefully scheduled follow up of aortic diameter progression, as a growth rate of >0.5 cm/y when ascending aorta is 5 cm in diameter (even when asymptomatic), or >4.5 cm (if you are diagnosed with any fibrillopathies such as Marfan, or Ehlers Danlos, etc.), or if the signs of aortic dissection appear, are clear indications for urgent surgery.
2) A close monitoring of blood pressure, to prevent potentially increased high values, in conjunction with a thorough investigation, to identify possible causes of aortic dilation (connective tissue disease, possible infection, systemic disease, etc.).
Meanwhile I would strongly agree with your radiologist, that you should be alert and follow up periodically your aortic diameter.
You should also talk to your husband, and explain to him that for the moment the situation is not problematic, but a careful supervision is needed in the future.
If no progression is seen with the time, there is no need to intervene.
Hope to have fulfilled your answer expectation!
I am at your disposal; whenever you need to ask further questions (you can also ask direct questions).
Best wishes,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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