6mm nodule after f/u for pulmonary embolism

over a year ago i was diagnosed with pulmoary embolism in both lungs, after a 6 month follow up to see if the clots went away the ct scan showed a 6mm density, my doc thinks its a pulmonary infarction since i had such significant amounts of blood clots in the lungs. the ... [More] xray tech put in his report that i should consider a 12 month follow up with out contrast...my doc is not consodering it in his report because the side where the nodule is where i had the significant amount of blood clots in the lungs...please advise me on this.

[Jigisha S. Amin, MD]

Without a complete history, physical, lab results and medication list, I can't give you an accurate diagnosis or treatment plan.  I understand your concern and confusion when the radiologist (the physician who interprets the films) says one thing and the pulmonologist or is it your primary care doctor who says another.  The radiologist has only part of the picture which is the film and radiologists often recommend futher films to follow up any abnormality that is found.  The primary care doctor or the pulmonologist has most of the picture (history, physical, labs, meds), so is usually the one in a better position to make the final decision, in conjunction with the patient.  Also remember there is a significant amount of radiation involved with CT scan and if the scan doesn't change the management of your problem, it may not be warranted.  However, your best bet would be to get a second opinion in the form of a visit to another pulmonologist.