chest x-ray shows nodular densities after chest

[judidca]

I went to the dr with chest pain & trouble breathing on exercise. Heart tests negative. Chest x-rays show 1 cm faint nodular density on thoracic spine & 2 smaller nodular densities in retrosternal region. CT recommended. Please help with interpretation. Should I be worried? Never smoked, otherwise healthy 40 something. Recovered from recent respiratory flu- after x-ray.

[Grand Rapids]

It sounds like you may have some lung nodules.  When most people hear this they jump to the worst conclusion, but since I had the same situation a month ago, I have done tons of research on my own and have talked to lots of doctors in the process.  The fact is, most lung nodules are NOT malignant. I had a routine annual physical with a chest x-ray that showed a small nodule a month ago. A following CT scan showed that nodule was 1.9 x 2.0 cm in my lower right lung and also found a smaller 4 mm nodule on my upper left lung.

I too had a horrific lung infection in January and February that was categorized as walking pneumonia at that time.  After the CT scan results, I went to a pulmonolgist who tested me for coccidioidomycosis and the test was positive for the IgG antibody and a comp fixation of 1:4. Coccidioidomycosis (aka Valley Fever) comes from a fungal spore prevalent in the Southwest U.S. and I had visited there 2 times last year.  Apparently, the coccidioidomycosis can produce lung nodules that mimic lung cancer nodules. There are a significant number of documented cases where this has occurred. Tourists are most susceptible to infections because residents tend to develop immunities. In the Midwest, there is also a fungus that can cause Histoplasmosis with similar symptoms.

I had a biopsy of the larger nodule, but the results were

[becsher]

A related discussion, Nodules was started.

[worrywart2]

Well, no growth is good news. I will be glad if this is the case for me.

I have read (and was told) that nodules a cm or greater with a negative pet scan have a 95% chance of being benign. Were you told this by your radiologist?

My nodules are under a cm so the negative pet scan is really not conclusive in my case, but I would think it should be in your case.

After seeing my pulmonologist last week, he decided I should wait until August for another scan. If that one shows no growth, I will have another in 6 months. I think when I brought to his attention that I have already had 3 within 6 months, he changed his mind about my having another so soon. The radiation risk I think is real.

[Grand Rapids]

Had my follow-up CT this week on my lung nodule and the results say nothing has changed- not bigger - not smaller.  I was hoping it would shrink but I'll be happy with "no change"

[worrywart2]

I suppose I am going to have to keep scanning...I was tested for valley fever and a host of other things which all came back negative (I was actually hoping for something so I could rule cancer out).

I guess what bugs me the most is the different sizes I keep hearing with each new scan. When I told this to the pulmonologist, he said that each one is different...if this is the case, how do you ever really know if it's growing and so what's the point? I thought they would do a match each time to the original but doesn't look like it. Seems they are not comparing precisely because you can't measure it precisely each time? Is this hit and miss if you get the same angle each time?

I'm losing confidence in the entire process.

[worrywart2]

Tom,

Do you need to go back every 3 months for 2 years for repeat ct scans?

My frightening ordeal began last November. I had an abdominal ct scan done for a slight, persistant pain on my right side. The ct found nothing there, but clipped the bottom of my lungs and found a 5mm lung nodule in the lower left lung.

I went to a pulmonary specialist after doing research on the internet. He had me go back for a full chest ct scan  2 weeks later which revealed the nodule was 9mm and another nodule was found in the opposite lung (4mm).

I was told to repeat scan in 3 months. In Feb, I went to another specialist because I was going crazy and wanted an immediate answer. I went to an oncologist who took a zillion blood tests and arranged for a pet ct of my entire body. The pet scan came back pet negative and in this scan, the left nodule measured in at 6mm. The right nodule could not be found in this scan.

It became clear to me that each scan apparently is different and that I am getting no where closer to an answer. All this information is confusing beyond belief. To make matters worse, I went to yet another doctor who told me to stop all the ct scanning because I will kill myself from the radiation exposure. (had 3 ct scans in 4 months time) and now month 6, the polmonary doctor wants me to scan again.

I am to the point where I want to say "enough is enough" and just have a chest x-ray in 4 or 5 months to see if it grows. I am very dissapointed with the medical care I have been given and the lack of knowledge these professionals have. No wonder lung cancer is the leading killer of all cancers.

worrywart2

[Grand Rapids]

Yes, my doctor wants me to have a CT scan every 3 months and I am scheduled to go in on Monday next week.  The radiation has me a bit concerned, but I know I have a nodule in my right lung and I need to know if it's growing, staying the same, or hopefully shrinking.  My doc and the pulmonoligist believe it it a granuloma, the result of coccidioidomycosis (Valley Fever) and I am praying that's the case.  If it's getting bigger, I am going to have it taken out, so I really need to know and will risk the radiation.  All the experts, including the Infectious Disease specialist I saw beleive that it's going to be stable.

Tom

[National Jewish]

In general lifelong non-smokers are much less likely than smokers or ex-smokers to develop lung cancer - if that is what you are worried about.  And lung cancer is more common when you are older.  However, a chest CT scan may be very helpful to further assess the nature of the nodular densities seen on your chest x-ray.  It is the appropriate next test.  If your breathing trouble persists, you might also consider having spirometry.  This is a simple breathing test that measures how your lungs are working.

[judidca]

Thank you for your response and concern.  After much prayer, the follow up CT scan, several weeks later show the nodules are no longer there. It was attributed to an infection.

[Grand Rapids]

Thank you for letting me know your results.  I think the prayer makes more of a difference than anything else.  I am very happy you have such a good outcome.  God Bless

Tom