Nodules

[becsher]

I have worked as a respiratory therapist for 32 years. Last week I had a routine calcium scoring test because I have heart disease in my family and my cholesterol is borderline. This test is a CT scan and it came back showing multiple lung nodules and possible diagnosis of metastatic cancer. I ended up having a stat CT scan the next day with contrast which came back saying I had pulmonary AV malformations and needed another CT scan angiogram. That one came back saying I did not have the PAVM but back to the metastatic cancer. I have 9 nodules total most irregular, lobuated and with pleural tags. I see the Pulmonologist in 3 days. I have never smoked and I am 54 years old and very active. This is really scary.


This discussion is related to chest x-ray shows nodular densities after chest.

[msg790]

Any more updates on this?  Hope all is well.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament. But please don't worry, as the nodal biopsy did not indicate a malignancy. Sometimes the lymph nodal enlargement could be due to infectious causes like tuberculosis. A direct biopsy of the pulmonary lesion or other nodes may help give a diagnosis. Please follow up with your doctor.

Hope this helped and do keep us posted.

[becsher]

Update...The PET scan showed the hilar lymph nodes with uptake and small uptake by the pulmonary nodules which was expected since they are smaller. The pulmonologist did a bronchoscopy and took samples of the hilar lymph nodes as they were easiest to access because the nodules are in the periphery of the lungs. The samples showed necrotic cells and macrophages. So the decision was made to wait until November and get another CT scan. If they are still there they will do an open lung biopsy. However, last Sunday I felt an enlarged lymph node under my arm and went to the doctor. She also found enlarged lymph nodes in my neck, supraclavicular area and back of neck by the occipital bone. These are small and not painful and all on the right side. She ordered another CT scan which I had done on Friday but will not know the results until Tuesday since Monday is a holiday. These are worrisome and everything I read says that 90% of supraclavicular enlarged lymph nodes are cancer. I feel ok maybe a little more fatigued than normal but I am still riding my bike without too much shortness of breath. Anyone have any ideas?

[Paderla Anitha, DNB]

Good Luck.

[becsher]

Thank you. I am having a PET scan done in 3 days. The Pulmonologist told me yesterday that they will do a needle biopsy once the results are back from the scan. Since I have never smoked and I am otherwise healthy with no symptoms, the Pulmonologist said that cancer is not high on his list as probable cause. Thank you for your response and encouragement.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament. Hope other body areas have been scanned for the primary. If undetected then next only a biopsy can help determine what the lesion is. A biopsy facilitates a histologic study of cells, which gives you a definite diagnosis. So once you have the diagnosis you will know what therapy is indicated. .

Hope this helped and do keep us posted.