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?
It seems that this patient has benign disease that is resolving: malignancy will not regress like that...
ReplyDeleteHowever, 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.
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).
ReplyDeletePresuming 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.
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.
ReplyDeleteHi,
ReplyDeleteI 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?
Thanks,
Brian