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1292320 tn?1525560578

Understanding CT scan impression

I had gone in for a abdoman CT scan (had minor possible pancreas issues which were fine)  and it caught part of my right lung.  And they saw some ground glass opacity and wanted me to come back for a CT scan of the chest  with contrast.  I am a 50 year old healthy female, 5'8, 132lb,  non smoker, no history of any lung disorders, never had pnu/or any upper respiratory infections. Having no symptoms at this time.  

Preliminary report: The heart size is within normal limits, No mediastinal or hilar adenopathy is present.

2cm area of rounded ground glass opacity in the right lower lobe. Differential most commonly includes infectious/inflammatory pnu.  As of note, some pulmonary malignancies can product ground glass opacity such as bronchoveolar cell carcinoma.  Treatment and ful to resolution in  4-6 weeks recommended.  As of note, the doubling time of ground glass malignancies is protracted. If this does not resolve on subsequent imaging, pulmonary consultation recommended for further evaluation.

I have not seen the doctor yet, I picked up this report from radiology.   I am curious as to what this may mean, do I need to worry .  Thank you for you time
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242587 tn?1355424110
MEDICAL PROFESSIONAL
The term lung opacity refers to any shadow on a chest X-ray or CT scan that is more opaque than the normal lung tissue surrounding it.  The term, “ground glass opacity” refers to refers to a hazy increase in lung opacity. This finding can reflect the presence of a number of diseases including infectious, allergic, diseases of unknown origin such as Sarcoidosis, non-infectious pneumonias, interstitial lung disease and tumors. The presence of such a shadow is worrisome but the good news is that it appears to be an isolated finding rather than associated with other abnormalities on the scan.

While some lung diseases may fall into this category and have specific radiologic features to suggest the diagnosis, more often it is not possible to make a diagnosis with any degree of certainty.  What that means is that it may be necessary to have a biopsy of the abnormal tissue to make a diagnosis but, before that, I offer the following advice.  
First, request of your doctor or the radiologist that the CT Scan be reviewed by a radiologist whose specialty is thoracic radiology; that is, the interpretation of abnormalities of CT scans of the lungs to confirm that the image is not an artifact and that concern about its nature is valid.  That same radiologist would then be the best person to make recommendations on further imaging techniques likely to provide useful information that might obviate the need for a biopsy. That imaging may well be a CT scan of the chest with contrast.

Second, you and your primary care physician should request consultation with a lung specialist (pulmonologist) for a second opinion.

Third, if your doctors suggest that you should have a biopsy of the tissue represented by the ground glass opacity, engage them in a discussion of the various types of biopsies with the risks of each and which type of biopsy is the technique most likely to provide enough tissue for diagnosis.  This will depend in part on how close to the surface or deep within the lung the tissue resides.  In some instances, a needle biopsy is preferable as it is minimally invasive.  In others, a biopsy or examination of lung fluid performed at the time of a bronchoscopy may be advisable.  A much favored technique at this time is the VATS technique, a minimally invasive technique that consistently provides enough tissue for diagnosis.  These days there is a subspecialty group of radiologists, who engage in what is called “invasive radiology” and such a specialist might be the best person to perform a biopsy.  

A specialist will often recommend the technique with which he/she is most familiar and performs most often.  The question that you must ask of any specialist is:  Given the size and location of this tissue abnormality, which technique is most likely to provide a diagnosis combined with minimal risk?

Good luck
Helpful - 1
1292320 tn?1525560578
Thank you very much, it has eased my mind.   My primary care physician has scheduled an appt for me with a pulmonary  specialist .    I have had no symptoms at all and due to my work environment he feels he maybe related to that or allergies at this time.   I am keeping my fingers crossed that this is not a big deal at all.  
Helpful - 0

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