Lung mass pneumonia

[phatyman17]

I am a 46 year old white male, have a history of anxiety and GERD.  I went to the hospital one week ago with chest pain and had a CT to see if I had any blood clots in my lungs. no clots however the radiologist noted a fairly homogenous subcarnial mass measruing 3.4 X 3.7 cm.  The doctor in the ER told me that the blood worked looked good and to check with my PCP but that he felt good that it was nothing major and my PCP would have me rechecked in 3 months.   I showed my PCP the radiologist write up and told her what the ER doctor said.  She said that she would check with the radiologist.  The next day her nurse called and said that she had set up an appointment for me with a vascular surgeon.  I asked the nurse if the doctor knew that I had pneumonia 3 months earlier (went to an instacare facility)the nurse call later and said that the doctor did not know that, thought it was interesting but still wanted me to go to the surgeon. 9 months ago I had a chest x-ray and nothing showed up but granulomas.  I had an x-ray of my back and chest (I think)5 months ago and they found nothing.  3 months ago I had an x-ray for pneumonia and took antibiotics and it cleared up (my son also had pneumonia a week later)I had the pneumonia for about a month before I went in.
So my questions are:  Could this just be from the pneumonia?  Can a radiologist tell the difference between mass and scar tissue? (he didn't know I had pneumonia) Also why a surgeon and not a pulmonologist. I have no coughing, little chest pain (but always have) What should be next step? Needle biopsy, CT again? VATS?

[National Jewish]

This is obviously not a definitive and clear problem up to this point and there are may questions still remaining to be answered.  Usually, you can tell the difference between scar tissue and a mass.  Resolution of pneumonia can create changes on an x-ray.  It is not know from the description why a surgeon and not a pulmonologist was consulted. However, because there is a possibility that this mass may need surgical biopsy because of its location, a surgeon was recommended.  It is certainly possible a repeat CT scan will be ordered.  The next step is seeing the surgeon.

[phatyman17]

I know the doc won't see this but I forgot to say that I have never smoked.