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Fat pad or nodule on chest x-ray
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Fat pad or nodule on chest x-ray

I had a chest x-ray, and the doctor called today to tell me that I need a ct scan.  He said there was a nodule or he also called it a fat pad, at he base of my lung near the heart and diapharm. What would cause a fat pad in my lung what will they do about it? Asking because I"m on vaction and won't be home for 2 weeks, is it okay to wait this long, for the ct. scan?
242587_tn?1355427710
The surface of the heart is covered by a membrane called the pericardium.  It is not uncommon for small amounts of fat to be found in and/or adjacent to the pericardium.  An increase in the mass/size of this fat deposit is associated with obesity.  This is benign tissue but when enlarged, and hence more likely to be visible on chest X-ray, is usually not a problem but it has been shown to be associated with coronary artery disease and other heart disease.  Once again, fat enlargement can, especially with obesity, be a benign finding, unassociated with any serious disease, heart or other.

As your doctor has suggested, it is not always possible to distinguish increased pericardial fat from certain types of nodules on a standard chest X-ray and the CT Scan is an accepted and effective technique to distinguish between the various possibilities.

Assuming that you are in otherwise, apparently good health, there is usually no urgency to proceed with the CT Scan.  An exception to that would be the instance wherein there is something unique about this X-ray abnormality that prompts your doctor or the radiologist to advise you to have the CT Scan without delay.  In the absence of that recommendation, there would be no reason for you to end your vacation and come home for the CT Scan.  In the meantime, prior to proceeding with the CT Scan, you and your doctor should do everything possible to locate previous chest X-rays, that you have had taken, so that those X-rays can be compared with the current one.  If the current nodule/fat pad was present in the past and unchanged, that could make it unnecessary to proceed with the CT Scan.

If it comes to pass that your doctors recommend surgery, be sure to ask if it could be performed, using a less invasive technique called VATS (video assisted thoracoscopic surgery).  Before you agree to surgery, you should also consider seeking a second opinion from a lung specialist (Pulmonologist).

The odds are in your favor that this incidental chest X-ray finding will prove to be not serious.

Good luck
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