my husband has had a dry cough and some wheezing for 2 mons treated with inhalers. he has also had some mild chest pain. cardiac wise, he is fine. this xray was compared to one 2 years ago. Hx of + ppd for 30 years. hx asthma, obese abdomen and ventral hernia. Ex smoker- quit 15 years ago, 1/2 ppd.
chest x ray reads: a round density about 3 cm overlaying the region of the cardiac silhouette on the PA view. Not fully visible on the lateral view. Does not appear to be a hiatal hernia; however, may represent a diaphragmatic hernia,. However, a mass my not be excluded. Minimal blunting of the right costophrenic angle may be due to pleural thickening of effusion. cardiac silhoette wnl. the hila and mediastinum show no gross abnormalties. trachea in midline.
Impression: chronic markings in the left mid and lower lung field. Nodular density as discussed.
He is scheduled for a CT scan of lung with IV contrast
what could this be? I know they have to r/o a neoplasm.
A round 3 cm. in diameter density if definitely calcified would most likely be what is known as a granuloma (a tissue response with scarring) usually the residual of a prior infection with TB or one of a number of common fungi. The first step, even prior to a CT scan, could be a careful review of any and all prior chest X-rays for comparison with the present X-ray. In some instances fluoroscopy, performed by the Radiologist allows him/her to exclude the presence of a mass or, if a mass is confirmed, gain additional information on the appearance of it and the likely diagnosis.
That this apparent density is “not fully visible on the lateral view” and not associated with any gross abnormalities of the hila and mediastinum is very good news.
The CT Scan can often provide information on the most likely diagnosis but, if there truly is a mass and no evidence of such on prior X-rays, a biopsy may be required to establish a definitive diagnosis.
I hope that there is no mass or, if one is found, that it proves to be benign.
Thank you so much Dr Tinkelman. My husband had a CT Scan of chest with IV contrast Thursday morning and is awaiting to hear from his PCP.
The chest xray report was compared to the previous on 10/2010. All have been with the same radiology group.
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