Cancer??

I am 59 and a pack a day smoker for 17 years.  Had a CT scan done about 3 weeks ago - the findings are: Numerous bilateral pulmonary nodules are identified, measuring up to 7mm in diameter.  The largest one is adjacent to the inor fissure on the right.  Mildly enlarged paratracheal lymph nodes are identified, the largest one is on the right measuring 11mm.  There are also multiple mildly prominent bilateral hilar lymph nodes.  No enlarged axillary lymph nodes identified. IMPRESSION: Numerous bilateral pulmonary nodules measuring 7mm in diameter, there are also multiple mildly prominent mediastinal and bilateral hilar lymph nodes.  Recommend further evaluation to exclude a primary malignancy, as these findings can be seen in the setting of metastatic disease to the chest.  Follow-up chest CT in 8 to 12 weeks is also recommended to document stability.  
Is there cause to worry?

[Dr Sharma]

Hi there. Secondary lung tumors manifest as discrete nodules, usually multiple, interstitial infiltrate or endobronchial lesions with or without distal atelectiasis and charcterisitc round appearance on xray chest. Any cancer has the ability to spread to lungs most common being bladder, colon, breast and prostate cancer. You will need a PET scan to confirm and differentiate from pneumoconiosis since malignant cells have higher rate of glucose metabolism.  Thus, the principle of PET scan is intracellular accumulation of FDG snd preferential accumulation of glucose in malignant cells, leads to visualization of malignancy on PET scan. It is the diagnostic and staging tool in cancer, assesses malignant potential in a pulmonary nodule if it is solid and more than 1 cm in dia. management would depend on the diagnosis. Primaries would need to be searched if these are secondaries. Hope this helps. Take care.