53 y/o male, non-smoker. On 9/3/15, had CT Urogram with IV Contrast looking for kidney stone issues (had Cystoscopy in 2008) which was unremarkable, however, the radiology report found:
A 3 mm nodular subpleural density is noted in the left lower lobe, present and unchanged from study of 10/3/2008. A 5 mm subpleural nodule is noted within the left lower lobe, series 6 image 3. This was not definitely seen on prior study, but may be related to lack of inclusion of this portion of the lung on
the field-of-view of images obtained. A dedicated CT of the chest is recommended for further evaluation of the remainder of the bilateral lungs.
On 9/14/15, had a CT Chest without contrast and the radiology report found:
The lack of IV contrast limits evaluation of the mediastinum. The visualized portion of the thyroid gland is unremarkable. There are shotty, nonenlarged lymph nodes in the mediastinum. No enlarged nodes in the axilla, hila or mediastinum.
Again seen are small nodular opacities at the lung bases bilaterally. A pleural-based nodular opacity in the left lower lobe (series 3, image 62) series measures 6 mm and appears not significantly changed. Another small pleural-based nodule measuring 4 mm at the right costophrenic angle (series 3, image 79), appears less prominent compared to the prior study, on which itmeasured 6 mm.
It is not recommended that I have IV contrast studies that often since i have Stage 3 Moderate CKD and I need pre-medication for allergic reaction to the dye (hives).
The impression from the CT chest was:
Tiny pleural-based nodules in the lungs measuring up to 6 mm at the left lung base and 4 mm at the right lung base. One of these is similar in size and the other is minimally smaller. If the patient is at high risk for lung cancer, follow up low dose radiation chest CT in 6 to 12 months is recommended. If
the patient is at low risk, consider follow up in 12 months.
Sensible to not follow up with contrast and to repeat in 12 months ?
Reply # - September 17, 2015, 08:04 AM
Hi wbfreedy,
Hi wbfreedy,
Welcome to GRACE. I'm sorry that these scan findings create concern and uncertainty. It is not unusual for a person of your age to have small, benign lung nodules. The fact that over an extended period one appears unchanged and the other actually seems reduced in size is not at all typical for cancer. You're not a smoker and if you have no other reasons to be considered high-risk such as exposure to radon, waiting and watching is a pretty standard way to approach follow-up.
Here are a couple of posts by Dr. West which may be helpful. The first is his post on Solitary Pulmonary Nodules. Although you have two nodules, much of the same thinking applies.
In the second he discusses the Imaging Features of Nodules. There is nothing in your scan report to indicate any of those features which would make the nodules more suspicious for cancer, but you can ask for clarification from your doctor or the radiologist regarding the appearance of these nodules.
I will just add that over the years I've been active here on GRACE, I have seen many posts similar to yours. In the vast majority of cases those members have never posted a follow-up, which indicates that their nodules did not turn out to be cancer.
I hope that's what you discover.
JimC
Forum moderator
Reply # - September 17, 2015, 09:34 AM
Thanks Jim. I appreciate the
Thanks Jim. I appreciate the insight and anything I learn which helps me understand things goes a long way.