Would like some help with this...

[sfmidwest]

I've been looking for answers everywhere and making myself nuts with what I'm finding. Happened upon this place and am hoping someone can shed some light on this. I was treated for bronchitis in early June, experienced a pneumothorax in July. On follow up chest xrays they found a pulmonary nodule in the opposite lung than the one that partially collapsed. This past Wednesday I went in for a CT scan, which they performed at first without contrast, then decided to use contrast for additional films. The conclusion part of this report reads: "Biapical emphysematous changes predominately on the right side. Presence of a spiculated lesion of the posterior segment of the right upper lobe that remains suspected even though it doesn't present significant contrast enhancement. Additional 2-7 mm nodules are seen at the leve anterior segment of both upper lobes. No mediastinal or hilar adenopathy. Probable simple biliary cyst of the liver."
Now I know that the "spiculated" edges are what they worry about, but what about the fact that this thing doesn't take up contrast? That lesion is 3mm. I do have an appointment with a thoracic surgeon on Wednesday, but didn't I jump a step here? Shouldn't a pulmonologist be consulted first? Any help or suggestions of what this stuff may all mean would be much appreciated. I've given myself everything I can think of this past week, and would like some "impartial" opinions. Thanks in advance! :o)

[National Jewish]

Spiculation is of concern but does not help to understand the meaning of your test results.  The 3 mm nodule you describe is very small and thus most likely benign.

The meaning of your test results can be influenced by these factors your age, your smoking history, your work exposure, the size and form of the nodule, and if there is calcification.  You should be seen by a pulmonologist with the experience and knowledge to factor all these variables into the decision-making equation.  Every effort must be made to find prior x-rays.  This would make it possible to determine if the nodule was present in the past and has not changed.

Do not simply accept surgery as your only choice.  At the same time you must not simply ignore this nodule.  The pulmonologist

[sfmidwest]

Sorry, forgot to mention that the lesion is not calcified.

[sfmidwest]

Thank you NJC, for your comments. On obtaining my test results from the CT scan, apparently this nodule is NOT 3 mm in size but 10mm. There are also 2 other nodules seen in the left upper lobe. The Histoplasmosis (cytosis?) is the first thing I thought of as well, but after talking to a thoracic surgeon this past Wednesday, he is talking about taking out my whole rt upper lobe. A bit radical at this point was my opinion, so I have scheduled appointments at Mayo with a Pulmonary specialist as well as a thoracic surgeon to follow if needed. My age is 42, in good health, walk 1.5 to 3.5 miles daily with no shortness of breath, tho I do have a past smoking history of 1/2 to 1 pack per day for the past 20 years. We do have bats as well as many birds in my area, I live in a rural Illinois community.  There is no history of cancer, lung or otherwise, in either side of the family. A chest xray performed in 2000 has no evidence of any nodules. Any other suggestions? As far as biopsies are concerned, can you tell me what I might expect as far as procedures, recovery times and the like? Again, thank you for your help with this, I seem to be facing something that I really never thought I would. :o(

[sfmidwest]

Helllllllllloooooooo out there...no one willing to comment, post advice here??