Chest CT Findings and Concerns
I’m a 48-year-old woman with a history of smoking. Recently, I underwent a chest CT scan prompted by the discovery of a pulmonary nodule in a previous x-ray. I will share my results and additional details shortly. **CT CHEST Summary:** The scan revealed several indeterminate pulmonary nodules that are new developments since July 2023. A CT scan of the abdomen and pelvis is suggested, along with a review of associated systems. A respiratory consultation may also be beneficial. Additionally, there’s a 5mm low attenuating nodule found in the right lobe of my thyroid. An ultrasound is recommended for further evaluation due to the pulmonary findings, recognizing that CT is not the best method for assessing this. The dense breast tissue observed is also challenging to evaluate via CT. It’s advisable to ensure that recent mammograms or ultrasounds are conducted and correlated with any clinical evaluations. **Clinical Context:** The CT scan was performed primarily for the evaluation of the detected pulmonary nodule. **Findings:** The report references a CTPA conducted on July 21, 2023. I have a clear central trachea and tracheobronchial tree, with no noteworthy lymph node enlargement in the hilar or mediastinal regions. Multiple pulmonary nodules were marked as indeterminate in nature on key images, with 86 nodules identified, mostly measuring less than 5mm. There is no evidence of cavitation, and the lung background does not strongly suggest sarcoidosis. While metastasis is a possibility, these nodules are currently regarded as unclear in significance and warrant correlation with previous imaging. There were no signs of pleural or pericardial effusions observed. The low attenuating thyroid nodule appears stable since 2023, though it was less distinctly viewed due to the arterial imaging technique. An ultrasound assessment is recommended for thoroughness, even though its morphology closely resembles earlier scans. The examination of the upper abdominal organs revealed no major issues in the arterial phase. No aggressive bone lesions were found. Earlier this year, in February 2023, an abdominal ultrasound revealed a 9x11mm mobile lesion with calcifications in my gallbladder. Although my GP didn’t express concern, I have a follow-up ultrasound scheduled. An abdominal CT scan conducted in April 2024 indicated bibasal subsegmental atelectasis and small bilateral effusions, with the right side being more pronounced. However, these findings appear to have resolved by the time of the current CT, with no pericardial fluid detected at that time. In addition, blood tests from September and November of 2023 reflected mildly elevated hemoglobin, white cell count, and MCH levels; however, these abnormalities have since normalized along with subsequent tests conducted as recently as a few weeks ago. I manage asthma fairly well and haven’t noticed any significant coughing or concerning symptoms apart from intermittent stomach discomfort over the last couple of years, which I attribute to stress due to personal challenges. I occasionally experience chest wall and back pain, likely exacerbated by poor posture. I do not have a known cancer diagnosis. My primary concern is whether the presence of these nodules could be linked to an infection or inflammation I might have experienced in 2023 that has resolved, or if there’s a greater likelihood that these findings are indicative of cancer, considering the number of nodules. So far, no follow-up scans or appointments have been scheduled, and I am struggling significantly with anxiety regarding this situation.
Answers (1)
8/30/2025, 2:24:17 AM
OpenHealth AI
It's understandable to feel anxious about the findings from your recent chest CT, especially given your history of smoking and the presence of multiple pulmonary nodules. Here’s a breakdown of the key points and actionable steps to help you manage your concerns:
Summary of Findings
- You have several new indeterminate pulmonary nodules observed since mid-2023. While these nodules can raise concerns, their significance is not yet clear.
- A 5mm low attenuating thyroid nodule has been noted, recommending further evaluation with an ultrasound.
- There are no signs of immediate worrisome conditions such as lung infections, significant lymph node enlargement, or aggressive masses, which is a positive sign.
Explanation
The presence of pulmonary nodules can result from various causes, including infections (like pneumonia), inflammation, or the potential for malignancy, especially in individuals with a smoking history. However, the majority of such nodules are benign, particularly when they are small and lack certain concerning characteristics (e.g., cavitation).
Your elevated blood test levels have normalized, indicating there may not be an ongoing infection or major health issue. The nodules also most likely do not stem from an acute infection given their indeterminate nature.
Next Steps
-
Follow-Up Imaging: It's essential to monitor these nodules since they are categorized as indeterminate. Follow up with your healthcare provider to schedule a CT scan of the abdomen and pelvis and to discuss additional imaging of the nodules to assess any changes over time.
-
Ultrasound for Thyroid Nodule: Ensure that the recommended ultrasound for the thyroid nodule is completed. This will provide clarity on its nature.
-
Manage Anxiety: Address your anxiety through stress-relief techniques such as mindfulness, deep breathing exercises, or talking to a mental health professional. It’s important to engage in activities that bring you calmness.
-
Posture and Physical Health: Given your experiences with chest wall and back pain, work on maintaining good posture and consider gentle stretching or physical activities that strengthen your back muscles. Consult with a physical therapist if necessary.
-
Monitor Symptoms: Keep track of any new or worsening symptoms, such as coughing, chest pain, or breathlessness, and discuss them with your physician when you meet next.
Reassurance
Your proactive approach to these findings is commendable, and addressing motion towards the next steps can significantly reduce your anxiety. Remember, while some uncertainty exists, many pulmonary nodules end up being benign. Stay focused on your follow-up and keep communicating with your healthcare team for support. If you have any immediate concerns about worsening symptoms, do not hesitate to seek medical attention.
Related Questions
Navigating Health Concerns: A Young Woman's Plight with Chronic Migraines and Stress
To summarize a very complex situation, last spring in 2025 was exceptionally challenging for me. I faced overwhelming stressors, including family deaths, eviction, and my parents splitting up. This turmoil led to chest pains so severe that I had to visit the emergency room because I couldn’t breathe deeply without experiencing intense pain. The doctors attributed the issue to psychological causes, but I continued to suffer from pain and instances of fainting due to the stress, which worsened as yet another family member was diagnosed with cancer. My psychiatrist suggested medication, and I started on Lexapro and Concerta, which improved my condition somewhat, even though I remained fatigued and felt like I was merely surviving. By the end of August, I contracted a severe case of bronchitis that caused me to experience fevers even while doing laundry. It seemed I was verging on pneumonia, prompting the prescription of prednisone and other steroid medications. Thankfully, I began to recover quickly, but soon after, I was plagued by persistent headaches and an overwhelming sense of paranoia that someone was out to get me. After another emergency room visit, the physicians informed me that, although my symptoms—such as fever, intense pain, night sweats, sensitivity to light, ear pressure, and a stiff neck—were alarming, they were likely just severe migraines that should eventually fade. Unfortunately, they didn’t. I returned to urgent care for further treatment, received antibiotics, and was advised to consult a neurologist. While the antibiotics provided some relief, my symptoms intensified. My primary care physician eventually prescribed sumatriptan, a medication intended to alleviate migraine pain, but instead, it exacerbated the headache. For the next two to four weeks, I endured an exceptionally difficult time, facing numerous strange symptoms that felt worthy of immediate attention, yet each visit concluded with a migraine diagnosis and a waiting period for my neurology appointment. My frustrations pushed me to contemplate risky alternatives for relief, but I resisted, feeling utterly hopeless and unable to cope. I sought an ear, nose, and throat specialist to rule out sinus issues, which turned out to be fine. A painful spot under my jaw led me to suspect nerve involvement, and I visited the emergency room again due to experiencing stroke-like symptoms (including mild left arm weakness, extreme headache, and minor speech issues). Sadly, I was again told it was merely a headache, and the IV medications were ineffective. During my annual check-up, my primary care provider was unfamiliar with my ongoing issues but discovered an enlarged lymph node in the lower left side of my neck and a cyst on my thymus after conducting a soft tissue scan. She reassured me that there was no need for concern and suggested waiting for my neurology visit or getting my eyesight checked. Despite my yellower complexion, increasing stiffness, and joint pain, I accepted her recommendation. While I mentally adapted to the chronic pain, which was always present, it affected my ability to concentrate and engage in daily life. I tried consuming plenty of lemon juice and engaging in lymphatic drainage massages, which provided transient relief and halted my yellowing skin. Now, in the present, I've noticed a peculiar, raised red bump on the side of my foot. It’s hard, tender, and smaller than a dime, without any accompanying rash. It has persisted for a couple of weeks without causing pain while walking. Additionally, more lymph nodes in my neck have become swollen, I have experienced difficulty swallowing, and I occasionally choke on air. My lungs feel heavier with a diminished sense of smell, though I don't have the thick mucus typical of a cold. The headaches, however, are reemerging, sharper than before, which is a concerning development. Throughout all of this, my blood pressure has remained within a low yet stable range, and my blood tests and CT scans have shown no significant issues. I haven’t consumed anything excessively that might raise concern, including food or drugs. Am I truly facing a serious health crisis? Should I prioritize getting another appointment, or do I need to rush to urgent care? I'm scheduled to see the neurologist in about a month, and I'm wondering if I should ask my primary care provider for some preliminary tests like blood work or an MRI beforehand. If so, what specific questions should I prepare for my neurology visit? I believe the pain has a genuine physical basis, although my anxiety definitely amplifies the experience.
Inquiry Regarding Metronidazole Use for Recurrent Bacterial Vaginosis
I am a 32-year-old female, measuring 5 feet 5 inches tall and weighing 248 pounds. My current medications include Vyvanse at a dosage of 40mg, a medication for asthma, vitamin D, a 325mg iron supplement, and as of now, I am also taking amoxicillin to treat strep throat. I am about to begin using Metronidazole 0.75% Vaginal Gel, with a total of 70 grams available. The instructions indicate that I should administer 5 grams vaginally twice a day for seven days, followed by twice a week for a period of two months. During the initial treatment phase when I will apply the gel twice daily, I anticipate abstaining from sexual activity. However, once I transition to the twice-weekly application, is it permissible to engage in sexual intercourse? I would normally consult my physician about this matter, but she is currently unavailable, and the nurse is also out of the office, which is quite frustrating.
Concern Regarding Persistent Tongue Bump with White Coating
I am a 24-year-old male, standing at 190 cm tall and weighing 109 kg. For the past five weeks, I've experienced a peculiar issue on my tongue. Specifically, there's a noticeable bump on the right side near the tip, which I believe may have been developing over time, although I'm not entirely sure about that timeline. Recently, I've been troubled by an unusual sensation, including dryness, an odd taste, and a slight decrease in my sense of taste. Additionally, I've observed a white coating that is more pronounced on the aforementioned side of my tongue. The bump in question: - Does not cause any pain. - May have increased slightly in size over the weeks, though I'm uncertain. - Appears smooth with a pink surface, free of bleeding or ulceration. Given that this issue has persisted for over a month, I am feeling quite anxious and am concerned that it may indicate a serious problem. I have no significant medical history, but I confess that my dental hygiene has not been up to par, as I haven’t been brushing regularly. At this moment, I’m also under medication for H. pylori, known as Pylera, but this tongue concern predates my treatment. I am a non-smoker and am reaching out for any insights on this condition. Has anyone experienced something similar? Could this be a sign of irritation, infection, or something benign? I really appreciate any guidance you could provide. Thank you!
Experiencing Clear Fluid from Ear with No Discomfort: Should I Wait for My Appointment?
I am a healthy 57-year-old female, weighing 120 pounds and standing 5 feet 5 inches tall. My daily medications include 100 mg of Losartan for effectively managed high blood pressure, 200 mg of Lyrica taken twice daily for post-herpetic neuralgia, 100 mg of Synthroid following treatment for thyroid cancer, and a combination hormone replacement therapy patch. Additionally, I take Zyrtec and Flonase every day to combat allergies. Since October, I have been dealing with persistent tinnitus in my right ear, accompanied by some pressure and a muffled sensation. Recently, I've noticed that when I speak, it feels akin to the sensation I experience when my ears clear during a flight after chewing gum—my voice sounds amplified in my head. I've scheduled an appointment with a physician's assistant in an ear, nose, and throat (ENT) office for the end of March due to my worries about the tinnitus and any potential hearing impairment. Yesterday, I noticed that my ear emitted a clear fluid. Thankfully, there was no associated pain. The fluid was somewhat thicker than water, completely odorless—unlike the unpleasant discharge I recall from my daughter's ear infections—and there was no sign of blood. Could this indicate a perforated eardrum? I suspect this might be the case, but can this occur without an underlying infection? Should I seek attention sooner than my appointment in March? I would prefer to avoid urgent care during flu season; however, if this situation is serious, I am prepared to take precautions and visit.
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.