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Respiratory Disorders (Expert Forum)
Abnormal chest x-ray and blood in sputum
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Abnormal chest x-ray and blood in sputum
by Redchez200, Sep 13, 2005 12:00AM
My dad underwent a heart bypass operation 4 months ago and he appeared to be recovering well.
However in the last couple on weeks he has noticed blood in his sputum. He went to the doctors, who put him on antibiotics and sent him for a chest x-ray. The antibiotics did not work fully -though the blood became more pinkish and less regular. The results of the x ray have now came back and they have told him that there is a spot on his lower left lung. This was also there on a x-ray they did at the time of the heart bypass (though no one told him), but in 4 months is has grown by about 2mm.
Other than that he has no other symptoms. He rides a bike regulary and has experienced no fatigue or shortness of breath.
The doctor has now advised that he goes for to see a specialist which won't be for another 10 days. He is extremely anxious. My dad smoked less than 10 a day for a long time but gave up about 9 months ago. He is 57 and has worked in industy exposed to chemicals.
The doctor mentioned lung cancer, but could be other possibilities. What other possibilities could there be with the symptoms he has got?
However in the last couple on weeks he has noticed blood in his sputum. He went to the doctors, who put him on antibiotics and sent him for a chest x-ray. The antibiotics did not work fully -though the blood became more pinkish and less regular. The results of the x ray have now came back and they have told him that there is a spot on his lower left lung. This was also there on a x-ray they did at the time of the heart bypass (though no one told him), but in 4 months is has grown by about 2mm.
Other than that he has no other symptoms. He rides a bike regulary and has experienced no fatigue or shortness of breath.
The doctor has now advised that he goes for to see a specialist which won't be for another 10 days. He is extremely anxious. My dad smoked less than 10 a day for a long time but gave up about 9 months ago. He is 57 and has worked in industy exposed to chemicals.
The doctor mentioned lung cancer, but could be other possibilities. What other possibilities could there be with the symptoms he has got?
Doctor's Answer
by National Jewish, Sep 25, 2005 12:00AM
, Sep 25, 2005 12:00AM
We can presume that the spot on your father's lung is the cause of blood in his sputum. That may or may not be the case. Any growth of a spot, even just 2 mm over a short period of time, is worrisome. At the same time, growth of 2 mm may be more apparent than real, depending upon the technique and positioning used to take the chest x-rays.
Such a spot can but may not be a cancer. Other possibilities include a tumor that is not cancer, an acute or chronic infection, abnormal blood vessels, a blood clot, or granuloma, which is an area of inflammation. Ten days is not a long time to wait, but the anxiety can be considerable. As long as there are no signs of active bleeding, waiting 10 days is not a dangerous thing to do.
A chest CT scan is usually the next test that is done because it is more sensitive and shows more detail than a chest x-ray. The shape, smoothness, and density of the nodule will be seen on the CT scan, even without contrast. This may help in determining what this spot could be. However the pulmonary doctor may need to do further testing to find the answer.
A lung biopsy provides the specific answer that the CT scan cannot. During a lung biopsy tiny pieces of lung tissue can be taken for further testing. A lung biopsy is done to be certain about the diagnosis. Only then is it possible to say what treatment would be most helpful. A biopsy may be done by bronchoscopy. During this procedure a tube called a bronchoscope is passed through the nose into your windpipe to look into the lungs. A bronchoscope is a flexible tube with a small camera at one end. When spots are small, it is possible that the lung tissue taken by biopsy is from an area of normal lung rather than the spot. This lung tissue will of course be normal and not tell anything about the nature of the spot.
If it is determined that the spot needs to be removed by surgery, ask your father’s doctor if it can be done by video-assisted thoracoscopic surgery (VATS). This is a less invasive surgical procedure in which the lung and surrounding tissues are examined through a scope with a small video camera at one end of a flexible tube. This scope is placed through a small incision between the ribs into the chest.
Good luck.
Such a spot can but may not be a cancer. Other possibilities include a tumor that is not cancer, an acute or chronic infection, abnormal blood vessels, a blood clot, or granuloma, which is an area of inflammation. Ten days is not a long time to wait, but the anxiety can be considerable. As long as there are no signs of active bleeding, waiting 10 days is not a dangerous thing to do.
A chest CT scan is usually the next test that is done because it is more sensitive and shows more detail than a chest x-ray. The shape, smoothness, and density of the nodule will be seen on the CT scan, even without contrast. This may help in determining what this spot could be. However the pulmonary doctor may need to do further testing to find the answer.
A lung biopsy provides the specific answer that the CT scan cannot. During a lung biopsy tiny pieces of lung tissue can be taken for further testing. A lung biopsy is done to be certain about the diagnosis. Only then is it possible to say what treatment would be most helpful. A biopsy may be done by bronchoscopy. During this procedure a tube called a bronchoscope is passed through the nose into your windpipe to look into the lungs. A bronchoscope is a flexible tube with a small camera at one end. When spots are small, it is possible that the lung tissue taken by biopsy is from an area of normal lung rather than the spot. This lung tissue will of course be normal and not tell anything about the nature of the spot.
If it is determined that the spot needs to be removed by surgery, ask your father’s doctor if it can be done by video-assisted thoracoscopic surgery (VATS). This is a less invasive surgical procedure in which the lung and surrounding tissues are examined through a scope with a small video camera at one end of a flexible tube. This scope is placed through a small incision between the ribs into the chest.
Good luck.
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Since I first posted, my Dad had a period of a week where he had no blood at all. He has had two course of antibiotics (different types). After the first course the blood became pinkish. After the second course it stopped altogether for 7 days. It has since returned, but it not always red, it is sometimes pinkish.
My Dad has also been to see the specialist and like you said, he is due to have a broncoscopy and CT scan this week.
The specialist also said that they weren't sure the shadow had grown due to the angle of the x-rays. He also said that the shadow had a clearly visible sharp edge to it, which isn't typical of cancer - though quite understandbly they couldn't say it isn't cancer until futher testing is done.
We wait in anxiety.
My Dad went for his biopsy today and they told him that they could not find anything, and that he can go home and stop worrying.
They have told him that the shadow is likely be due to an infection from when he was young and that the blood in his sputum seems to be from bronchitis.
It is such a relief.
However it now appears that my Dad has lung cancer. He had a CT scan 2 weeks ago and when the results came back they said the spot needed further investagation. We have been told by 3 different doctors that the spot was 4cm, then 2 cm and now 5 cm, so we don't know which one is quite right.
He had a CT assisted needle biopsy on Friday and the doctor said that indications look like the tissue is malignant though it appears operable as it is on the lung and not in it. The very worrying part for me is that they mentioned tiny spots on his lymph nodes, thought the doctor felt could be scar tissue for a Heart Bypass operation he had in May 05.
We are waiting for results, and then we will know about stages and treatements etc. In the meantime my Dad is becming increasingly depressed.
I was really just wondering if there was anyone else who was going through a similar experience.