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
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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.
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Ultrasound for Thyroid Nodule: Ensure that the recommended ultrasound for the thyroid nodule is completed. This will provide clarity on its nature.
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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.
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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.
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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.
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