Tuesday, August 02, 2005

CT followup?

This question is from a doc in Ohio:

A f/u CT was done on a patient 1 and 1/2 months after RUL community-aquired pneumonia.
The reading was: "Small focal pneumonic process in the anterior subsegment of the right upper lobe. The 2 tiny nodules in the right lower lobe likely represent
noncalcified granulomas or intrapulmonary lymph nodes."

Does this patient need any more f/u CT's based on thsi interpretation?

5 comments - CLICK HERE to read & add your own!:

Baleeiro said...

It seems that this patient has benign disease that is resolving: malignancy will not regress like that...
However, I would like a bit more info: is this a smoker? How are his symptoms?
There is some merit to radiographic follow-up (which could probably be done with plain chest radiographs): some chronic conditions that are not malignant (atypical mycobacteria, autoimmune Dz) may fluctuate with therapy but not resolve completely.

Mike L said...

If the patients' symptoms are resolving, I would repeat imaging again in about 3 months (like finding an abnormality for the first time on a CT).
Presuming the nodules on the CT are too small to be seen on plain film, I think that f/u with CT is going to be required.

Mendez said...

I agree with Baleeiro and Mike Ls remarks.
Before I'm comfortable calling this resolving pneumonia(aside from clinical exam and history) I would like to know what the initial imaging was at the time of Dx.
Incomplete resolution on CT at 6 weeks would not be uncommon with advanced age.
If this patient is a smoker - I would f/u with CT scan in 3 months to document stability of nodules and complete resolution of the consolidation in the RUL.

Anonymous said...

Thank you. Yes she was a heavy smoker (2 1/2 ppd) quit 4 years ago. The original CT at the time of the pneumonia showed a RUL infiltrate without adenopathy. The f/u CT showed improvement. Symptomatically she is improved. I will repeat the CT as suggested. Thanks again.

Anonymous said...


I was given this diagnosis today and have never been a smoker. The only difference is that it's my left lung and not my right lung. I've had 2 CT scans in the last few weeks (one was to find something unrelated where they discovered the nodule). When I had the second one last week, I got this same diagnosis today.

Any thoughts of what this is and why a non smoker would have this?