The denser a "spot" is, the more likely is it to be benign. In this case of a young man with a modest smoking history and no other risk factors, the odds are high that this shadow is the residual of a prior infection, and of no significance. Cancer is always a possibility but in this instance the likelihood of it is extremely low
I recently had a xray that showed a possible nodule or a problem of some type that needed to checked further. I went for a cat scan ended up what they were seeing was a area where the blood vessels meet on the front view and the lateral view It was arthric changes and bone spurs. I had myself a nervous wreck until I had the scan. Hopefully your husbands will be the nothing at all.
Lots of luck, Linda
My husband went through a similar situation in 1982 when he was 31 years old. He was still smoking at the time. Back then, they took "routine" chest xrays with a physical. His doctor called and said there was a spot on his lung. He threw out the cigs that day and never went back to them. He had tried to quit three times but that was the final straw.
In the days before CT scanning, they ended up with doing tomogram xrays of the spot (different angles sequentially) and followed the spot for three months. One doc wanted to do an open lung biopsy, which my husband said absolutely NO to. They finally ended up doing a needle biopsy through his chest wall (after a bronchoscopy that didn't turn up anything). Lo and behold - it was an abscess. The pus grew Hemophilus influenzae, a common respiratory pathogen. He was an absolute wreck for about three months. His doctor was amazed it was an abscess, as it "didn't look like an abscess" on the xrays. The only symptom he had, looking back, was really bad breath. I had remarked on it, but since he had no other symptoms, I never connected the two. He was on blood pressure meds (beta blockers) at the time that they concluded were causing bronchospasm - hence the abscess - so they switched him to something else.
We're going through a weirdly similar circumstance presently. He had a real bad cold with a cough that produced hemoptysis (spitting up blood) about three weeks ago. He finally ended up on a course of Levaquin but, because of the bleeding, he had a chest xray which was a bit funky, and then his doc ordered a CT of his lungs. He has had asthma since the mid-80's, although it's not incapacitating. He uses inhalers, etc.
The CT showed some localized bronchiectasis and some other spots that the radiologist couldn't quite be sure they weren't cancer, although they're probably not. However, he DOES have a very bad family history, with his father, two aunts (his dad's sisters) and one of the aunt's children all having had lung cancer. Only his one aunt is still alive (they were all smokers). The pulmonologist said there's only about a 3% chance there's anything metastatic down there, but because of his nasty family history, he's having a bronchoscopy (again) next Wednesday.
He's saying he's not that nervous, although I'm sure he's fibbing. We've been through a number of cancer scares with him through the years (neck nodule, the lung thing, hearing loss in one ear [r/o acoustic neuroma]) so he's learned to hide his hyperness from me. However, I can't say that I'm not concerned a bit, because I am on this one.
Maybe a lot of booze is the choice - I don't know. All kidding aside, distraction and keeping him busy is about the only thing that works. My husband broods about this stuff a lot and gets quite depressed. As I see it, brooding only makes it a lot worse.
Any chance you can move that appointment up? Pleading insanity sometimes works...
Good luck - let us know what happens.