If you can help me understand my CT Scan of lungs (high resolution). Details below. I see my pulmo doctor in 2 weeks when the new second opinion PFT tests are done for prior diagnosis COPD - emphysema.
I feared what might show up with age, including lung cancer. Some good news, I think, are small nodules in the lower lung that I'm reading are normally benign, but can be monitored as possible pre-cancer (I had skin basal cell cancer).
The doctor thought we'd see some effect of the exposure to cement dust inhaled decades ago, and perhaps that is represented. (I quit smoking in 1978).
The scan was done with my breathing in and out. Emphysema doesn't seem the problem. "No overt emphysematous changes are visualized. There is very mild air trapping but no substantial mosaic pattern of lung attenuation." Also, "There is mild bronchial wall prominence and borderline bronchial dilatation …"
HISTORY: Interstitial lung disease. Chronic cough, cement dust exposure, rule out interstitial lung disease versus emphysema.
1. No stigmata of
interstitial lung disease or substantial emphysematous change.
Borderline bronchiectasis and bronchial wall thickening with very mild
2. No confluent infiltrate. No tree-in-bud nodular
pattern to suggest endobronchial spread of infection in the background
of bronchial findings.
3. Essentially innumerable small bilateral
pulmonary nodules with a basal predilection, measuring up to 6 mm in
both lower lobes. These could be postinfectious/postinflammatory given
the multiplicity of similar findings, however follow-up is recommended
in 6 months in this patient with history of cancer.
4. Additional groundglass nodule measuring 3 mm in the right lower lobe.
The tracheal bronchial tree is patent centrally. There
is no substantial subpleural reticulation, honeycombing fibrosis, or
other stigmata of interstitial lung disease. There is no substantial
interlobular septal thickening. No overt emphysematous changes are
visualized. There is very mild air trapping but no substantial mosaic
pattern of lung attenuation.
There is mild bronchial wall
prominence and borderline bronchial dilatation in the distal downstream
bronchioles both in the upper lobes and at the lung bases. There are
tree-in-bud nodules are visualized. There is no confluent infiltrate.
is no pulmonary mass. Calcified granulomas are noted bilaterally. There
are multiple pulmonary nodules in both lungs, right greater than left,
with a lower lobe predilection. Most of these nodules appear to be solid
and subpleural, however there is a groundglass nodule in the right
lower lobe posteriorly measuring 3 mm (series 6, image 149). In the
right lower lobe, there are solid 6 mm nodules (series 6, images 159 and
117). Other smaller nodules are also noted in the right lower lobe on
series 6, images 171, 210, 230, 122, 93, 104. In the left lower lobe,
scattered small nodules are noted measuring 4 mm or less (series 6,
images 142, 146, 156, 131, 112, 104, 92, 99). The largest nodule
measures 6 mm in the left lower lobe just above the left hemidiaphragm
(series 6, image 73).
The heart is top normal in size. The
pulmonary trunk is prominent but not frankly dilated. The thoracic aorta
is of normal caliber. There are no suspiciously enlarged mediastinal,
thoracic inlet, or axillary lymph nodes.
Limited evaluation of
the upper abdomen demonstrates no adrenal mass. There are multiple
low-attenuation masses in the liver most compatible with benign cysts.
There is a cyst at the mid to lower pole of the right kidney anteriorly.
There is no evidence of acute thoracic compression deformity. Bony demineralization is suspected. The sternum is intact.