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spiculated lung nodule, maybe granuloma?

Hi,

I am a 59 year old male, former heavy smoker.  Currently have mold illness from workplace exposure.

A recent Ct scan revealed  a spiculated 8mm nodule centally and inferiorly in the left upper lobe of my lung.

There is no contained calcification.  A small neoplastic nodule is the diagnosis of exclusion.

Booked for a PET scan occuring tomorrow.

Will this PET scan be able to determine if a cancer or if not?   Could the PET scan tell if it is a granuloma?

I am wondering if I may simply have a granuloma from mold spores inhalation that is benign?

Any replies/opinions appreciated.

Thanks,  Ian

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Avatar universal
Dr. Anitha,

I am not sure what you mean by asymptomatic and was wondering if you could expand on this?  

A follow up Ct scan was done 2 weeks ago(sept. 10) and the report states the nodule is unchanged in size or appearance despte the somewhat sinister appearance of the 8-mm nodule.  

Another follow-up scan is being scheduled for January.

Could you please advise me WHAT blood tests in particular would be of good diagnostic value?

In terms of mold being the culprit, is it possible for a sinister appearing spiculated nodule to form that mimicks a cancer?  Would a mold produced nodule change in appearance and size over time too or would it remain constant in appearance?

And if it is in fact a nodule caused by mold fungi, would this nodule be causing me any symptoms in my body beyond the lungs?

I will mention that I am quite ill with a lot of neurologic consequences, some of which are:

Chronic severe headache, forehead, upper head, upper face and around eyes.
Vision problems with focus issues and distortion and fluctuating weak  vision
Very dry mouth and eyes
Chronic eye pain, quite severe
Chronic tinnitus
Debilitating muscle cramping and hurt
Fybromyalgia
Peripheal neuropathy and overall skin numbness
extreme muscle weakness and aching and pain
Chronic stuffy, blocked nose
Changed cognition, brain fog, etc.
Photophobia
Photosensitivity
Dermal changes incl. leathery skin palms of hands. skin sores over my back, goosebumps over legs,abdomen,forearms,upper arms.
General malaise and dizziness all times.

Thank you for your help and reply so far,

Ian
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hello and hope you are doing well.

Yes sir, if you are asymptomatic now, you could wait and watch and follow up wit a CT scan to see for changes in the nodule. Sometimes blood counts could help determine if the changes are due to an infection or due to allergic causes like mold.

Hope this helped and do keep us posted.
Helpful - 0
Avatar universal
Thank you very much for your reply.

I had a PET scan done recently and the radiology report states that 'lack of significant fdg uptake within the 8mm nodule in the left upper lobe tends to favor a benign etiology such as postinflammatory scar or possibly granuloma.  

My pulmologist has ordered up a followup ct scan which will happen in 2 weeks time.  He tells me that the PET scan is inconclusive as the test produces a lot of false negatives, especially on small nodules.  He is watching for changes.

A friend who is a neurologist thinks I should seek a thoracic surgeon as he thinks that looking is better than watching.  So, for now am going with the watching and follow-up ct scan.  The pulmologist has 42 years experience.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hello and hope you are doing well.

X rays are images and can show radiolucent or opaque shadows. And only a differential diagnosis can be obtained from this. Lung nodules can occur due to local causes like recurrent lung infections and sometimes due to cancer of the lungs. They can also be seen in systemic diseases like systemic lupus erythematosus, rheumatoid arthritis, sarcoidosis and scleroderma. Further evaluation will be based on whether the nodule is changing in size and systemic symptoms. A PET scan and biopsy may help in evaluation. A biopsy facilitates a histologic study of cells, which gives you a definite diagnosis. So once you have the diagnosis you will know what measures or precautious you need to follow.

Hope this helped and do keep us posted.
Helpful - 0
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