Lung Nodules

Can you please explain to me in simple terms what these test results mean. Also, can nodules be ON the lungs or are nodules always found IN the lungs? Please clarify.

Here are the findings: In a recent CT scan the Dr. noticed multiple questioned small pulmonary nodules. The largest 4mm in size seen in the region of the apex of the left upper lobe. They feel it may be a small area of rounded scarring since it appears to be pleural based and immediately adjacent to a rib.

There are other tiny questioned nodules that are scattered in the lungs bilaterally, most ranging in 1 to 3 mm in size. These may all be areas of nonspecific minimal interstitial disease or tiny vessels seen on en face. No significant hilar or mediastinal adenopathy is identified.

Thank you!

[National Jewish Health]

4mm nodules are considered to be quite small nodules.  The location of scarring, at the apex or top of the lung, and the description of it suggests that it might be a residual infection, not uncommonly tuberculosis, and of little or no consequence.

Nodules are usually IN the lung but can also be ON the lung.  Ones that are ON the surface of the lung are "pleural based" meaning, in close proximity to the pleura, the pleura being the membrane that encases the lung.  Most of these nodules, in an otherwise healthy individual are called inflammatory. The inflammation can be in response to infection or the inhalation of irritants.

The significance of multiple nodules must take into account one's history, including occupational exposures, and not be based simply on the appearance on the X-ray or CT Scan.

The best advice we can give is that you seek consultation with an experienced pulmonary specialist (pulmonologist), who should be able to put these findings in perspective.

Prior X-rays should be reviewed for earlier signs of the presence of nodules.