I was recently diagnosed clinically with pneumonia. My primary physician ordered a chest X-ray. The "Comment" said that in addition to the (expected) infiltrate, "there is a questionable small nodular density overylying the right lower lobe. " He recommended a follow-up CXR to ensure that the infiltrate is resolved and "for further evaluation of the nodular right lower lobe density and if persistent, CT is recommended." My parents were both smokers (cigars, cigarettes) and I grew up breathing alot of second-hand smoke, my mother worked in the shipyards (WWII - asbestos) and died of lung cancer although had nothing else wrong with her. I cared for her and know lung cancer is one of many diseases I don't want to be diagnosed with. I smoked minimally in HS and college - nothing for the last 35 years. Otherwise quite healthy. Any thoughts on the small nodular density?
Your primary physician’s recommendations are sound and you should follow them. Resolution of the pneumonic infiltrate may be accompanied by disappearance of the nodule and that would erase all concerns. The majority of small nodules, which are less than 2 cm in diameter, are benign, especially in non-smokers or those whose exposure was only second-hand. However, if your mother carried asbestos fibers home on her clothing that would pose a slight additional risk. If the nodule persists, following resolution of the pneumonia shadow, the radiologist may be better able to speculate on its origin, based on size, shape, density, smoothness and the presence or absence of calcification.
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