lung nodule

[jackie4763]

I went to a doctor for a TB screening x-ray because I can't have the Mantoux skin test.
The x-ray showed  findings: 1cm nodular density overlying the sixth anterior rib near the costochondral margin. ,conclusion: questionable pulmonary nodule verses prominent end of the Rt. sixth rib.
They did not clear me for TB at this point, notified( and alarmed my employer that they "saw a spot" on my x-ray-Hello Hippa ! ). Could this be TB?  I need to be cleared from this TB issue so i can work.
My issue is that, as well as not wanting to have a CT. I have had so many CTs and MRI's (7 CT's and 2 MRI's) in the past 2 years. Not to mention CXR's. I'm about glowing now !!!  I don't want to have more. Just want to be able to work. In reading many other horror stories of nodules on posts here, I'm wondering if it's really worth the effort. And, I still need to be cleared of TB tho. ugh. What are the chances this is TB or cancer?

[Dr Sharma]

Hi there. I understand your predicament and angst about your current situation. A solitary pulmonary nodule on xray chest needs to be evaluated whether it is benign or malignant and needs surgical resection or not. Usually all solitary pulmonary nodules are benign but may represent an early stage of cancer. Solitary nodules causes, are due to neoplastic(benign or malignant), metastasis, lymphoma, hamartoma, connective tissue tumors. It could be a granuloma of tubercular origin, lung abscess etc. CT halo sign or ground glass attenuation surrounding the nodule on CT image indicates TB and biopsy needs to be done bronchoscopically or via Trans thoracic needle aspiration. This should confirm the diagnosis since it could be tubercular due to compromised immunity from chemoimmnunotherapy or cancer reccurence.. Hope this helps. Take care.

[jackie4763]

Thanks for your reply julieben..... In re-reading my post, I guess I didn't make it clear as to WHY i had all those CT's and MRI's ( which left that wide open.) I have cancer and had surgery 2 years ago. Ended up with strange symptoms in my head and weakness so ended up with brain MRI's. Most CT's were done pre-post surgery for the tumor removal surgery. etc. But none  were done related to the most recent CXR to screen for TB. So, guess I'm wondering what are the chances of the " nodule" being TB or Cancer ( possibly mets from the primary tumor site) On a side note, interestingly enough. I received BCG ( immunotherapy Chemo) for the prior tumor 2 years ago, which one of the side effects was possibly contraction of TB. Makes it a bit of a crap shoot for if this Nodule is actually TB, or something else( infection,tumor,mets etc.) Oh Bother! as Pooh would say. Gotta look on the bright side tho, If I had not been x-rayed for employment screening for TB, this would have gone on un-detected, as I am asymptomatic for the most part. But also, to answer your question. Yes they gave info to my employer because they had ordered the CXR for TB screening, therefore have privy I guess to ALL the resluts of the CXR. So much for HIPPA is all I have to say. !! Bugs me too that you can go get tests done and they always make a big stink about if they can hand you a test result, but everyone else gets sent one with out even requesting it.!! I'm done !

[julieben]

Wow 7 CTs and 2 MRIs.  That is alot - ... and they gave the information to your employer?  That does seems to be a HIPAA violation.  So you had all this testing without knowing what you have or don't have?  Maybe you need to get a need doctor to read the CTs and MRIs and advise you on what the next step should be.  Best wishes.