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Lesions from Histoplasmosis 40 years ago or Lung Cancer?

I have a male friend 62 years old who recently had a low dose lung cancer screening as part of a physical exam. He was diagnosed with histoplasmosis 40 years ago and was treated successfully for it. It was bad. He almost died. But he got better and went on with his life. He has been a pack a day smoker for approx 42 years. The Impression on CT results was "Macro lobular mass on right upper lobe 7.2 cm in size that is solid with punctate calcifications within it. It abuts anterior wall and it is difficult to say if it involves the wall or not. No involvement of underlying rib." He also has multiple calcified nodules on left lung and one noncalcified nodule also on left lung.. These are 6 mm or less. The question is could this mass be from the bout with histoplasmosis? The doctor told him back then that he would have lesions on his lungs for the rest of his life. He is very scared and cannot see the doctor until May 22, 2019. Any response would be much appreciated.
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15695260 tn?1549593113
Hello and welcome to the forum.  You sound like a good friend and we appreciate your asking about your friend's situation.  I'm sure you are both concerned.  Your question is difficult to answer without a full heath history though and is best asked of his health care professional.  His doctor may be able to take a phone call question of this sort before his May 22 appointment.

In the mean time, calcifications of nodules is indeed common after a health issues such as he had and are typically benign.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883201/.  When dealing with the lung, nodules classified as calcified, they often are less likely to be caner related.The macro lobular mass and it's size are a bit more concerning but again, please have him speak to his doctor about this. What makes a mass different than a nodule is the size.  Anything smaller than 3 cm is called a nodule and anything larger is considered a mass. The fact that he is a long time heavy smoker does put him at higher risk, obviously.  However, the calcifications associated with the larger mass is a good sign that this is likely benign.

Again, this is not to be used as an interpretation of his results as that needs to come from his doctor but is some basic information to help inform.  Let us know how things go.  
Thank you so very much for your response...it made him feel a little less frightened.
@jeanette1952 my own experience with a 13mm nodule identified on an x-ray was that it was diagnosed as benign after a CT with contrast performed in 2008 showed it to be calcified.  Like your friend I have a low dose CT screening performed annually and have done so since 2014.
15695260 tn?1549593113
Jeanette1952, I wanted to check in to see if there has been any update with your friend?
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On Wednesday 6/12/2019 he will b  biopsied. I will post back then. Thank you so much for your caring responses. So, so much appreciated.
15695260 tn?1549593113
We wish him the best of luck.  Please do come back and let us know how it goes and the findings.  
He went and had his blood work done and the doctor came in and talked to him about the procedure and he got scared and told them he would reschedule. So it  is now set for 7/9/2019. I was so shocked I couldn't believe it. No sign until almost the last minute/ He swears he will do it this time. God I hope so.  
I'm sure this is all very worrying for you.  I hope he follows through as well.  Health anxiety is difficult to overcome and he must be quite scared.  I would suggest your keep encouraging him but with empathy.  please let us know about his appointment.
He went for the biopsy and got the results back Friday. He has adenocarcinoma.  He is seeing an oncologist on July 19, 2019 and will have a PET scan on the 25th.  I am doing my best to ease his fears.  He has no symptoms yet  The pulmonologist did PFT's and he has 85% lung function and an O2 saturation of 98%. So that is encouraging.  He has no other health problems. They were all shocked to learn that at 62 he takes no medications. His blood pressure and heart rate are great. No diabetes...glucose level of 80.  I keep reminding him that being healthy otherwise will be a huge help to him in the coming days. Thank you for being so kind.
I'm terribly sorry about his diagnosis.  That's a difficult thing to hear. Absolutely, going into treatment fully healthy otherwise will have a positive outcome on the effect.  His appointment was on the 19th.  How did it go?
I am sorry .... the appointment is on the 29th not the 19th.  Hit the wrong key.  I guess its on the 29th because the oncologist will have the results  from his brain MRI and the Pet scan by then. Since I sent the last post they have made him an appointment for a brain MRI as well as the PET scan. Will let you know what happens.  So nice to have a place to vent all of this. I really appreciate your kind responses.
15695260 tn?1549593113
Hello, I wanted to check back in. I'm hopeful that the appointment went well.  I'm sure this is a very trying time for your friend.
15695260 tn?1549593113
Hi there.  I wanted to see if there is an update on your friend.  I hope you have had good news and things are going alright.  Please let me know.
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