Single lung nodule....fungus infection?

[Tiz]

I have COPD, a recent CT Scan said the emphysema is about the same as it was 17 months ago on a previous scan, but my breathing is way WAY worse than it was then, for about 4 months now I've been have daily SOB spells that leave me gasping and panting for hours, with feelings of bloat, cramps in my diaphragm area, my sinus seems to suddenly form more mucus, my ears plug, my face feels swollen. The "attack" eases up after I cough up some light brown, dark-specked sputum.  Otherwise I rarely cough but I do have a small amount of daily sputum that I can usually get out easily by just clearing my throat..that sputum can be any color from very clear/whitish to light brown, always with tiny black specks.
     They found a single, irregular shaped nodule in my upper lung in Sept 2004, it was approximately 9.7 mm....two months later, another CT Scan showed it to be 11.7 mm.  They then went back and saw that the nodule DOES show on the CT I had done in June, 2003 ...back then the nodule was approximately 5 mm.  So, the nodule doubled in 15 months, then, in Nov it's 2 mm larger than it was in Sept.
     My lung doctor doesn't seem to think the nodule is connected to the severe SOB attacks I've been having.  Aspergillus fungus grows all along the wooden fence, I feed birds and sweep the patio every month or so, and after a flood black aspergillus grew all over my basement.  Can this nodule be an aspergillus infection??
     Thank you for your time and for your website.

[National Jewish]

Your doctor is probably right in saying that the nodule is not connected to your shortness of breath, but your doctor should try to determine the cause of your shortness of breath.  Bringing up brown sputum suggests some type of chronic infection.

While still small by our usual standards, this is a rapidly growing nodule.  It could be a nodule of Aspergillus called an Aspergilloma.  However, given the rapid growth, it should be surgically removed.  You should ask if it could be removed by the use of the video-assisted thoracoscopic surgery (VATS), rather than by conventional surgery.  VATS is a less invasive surgical procedure in which the lung and surrounding tissues are examined through a scope with a small video camera at one end of a flexible tube.  This scope is placed through a small incision between the ribs into the chest.

[Phee238]

A related discussion, Emphasema?? - Fungus Possible?? was started.

[Tiz]

Hi NJC, thanks for answering my question about this lung nodule.  I hadn't heard of the VATS surgery, I looked it up and it sounds so much less invasive than open lung biopsy that I feel less frightened about facing it now.  I'll have a new CT Scan in about 5 weeks and will find out then what I'll have to do.  I had a blood test to check for "Farmer's Lung" and for aspergillus fungus, the tests came back negative but said on the reports that a negative result doesn't mean that there ISN'T a fungal infection.  I live in Iowa and histoplasmosis and other fungus infections are really common here; I garden and I feed birds and clean up the droppings so I'm often exposed to fungus.  I still think this lung nodule is as likely to be an aspergilloma, like you said, as to be a cancer....no one in my family has ever had lung cancer, only a very few relatives have had any kind of cancer at all.  But I do smoke, I have emphysema, and I'm 54 years old, I understand I'm at great risk for cancer.



Do you know of any other tests I can do to check for a fungal infection or any way I can tell if this nodule might be fungus?  Thanks :D.................Tiz.