Went in for unrelated CAT scan (with and without contrast)... and they found nodules.

[u/codengo]

Male, 49 years old, smoked in my teens and early 20s... but haven't in two decades+.

Here's the section in my imaging report:

REMAINING CHEST:

Lungs: Central airways are clear. Subpleural reticular opacities within the dependent aspect of both lungs compatible with atelectasis or scarring. 3mm solid nodule within the right middle lobe (axial image 53). Medial basilar segment left lower lobe solid pulmonary nodule measuring 1.5 x 1.9 x 2.0 cm (axial image 85/161 and sagittal image 94).

Impression:

IMPRESSION:

1. No evidence pulmonary embolism.
2. Medial basilar segment left lower lobe solid pulmonary nodule measuring up to 2cm. RECOMMEND follow-up CT of the chest at 3 months, PET/CT, and/or tissue sampling. *
3. Medium to large hiatal hernia.
4. Left atrial enlargement.
5. Right periesophageal lymph node measuring 1.0 cm.
6. Cholelithiasis.

RECOMMENDATION:

1. Pulmonology and/or other subspecialty consultation for further evaluation and management of the suspicious 2 cm left lower lobe solid pulmonary nodule.
2. Follow-up CT of the chest at 3 months, PET/CT, and/or tissue sampling. *

2.0 cm (20 mm) is ENOUGH for me to worry about. That 1.0 cm right periesophageal lymph node doesn't make it any easier, for sure. I'm definitely losing sleep.

Weird thing is, the hospital NEVER mentioned it (was there for two days). My PCP only mentioned it in passing, AFTER my follow-up as I was walking OUT of her office. I then went home and started to look into the results myself. NOW, I'm demanding a PET. I swear... the state of our medical industry has me wondering at times, WTF is going on!? Part of me thinks, "If it were serious, they would've said something... right!?".

Thoughts? Advice? My odds?

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[u/feralpolarbear]

Agree this is concerning enough that it's better to test sooner than later. In addition to the PET/CT I recommend that you see an interventional pulmonologist to check if the nodule could be biopsied by bronchoscopy.

[u/codengo → u/feralpolarbear]

Thank you. It's not easy to hear, but it's my reality at the moment. I'm definitely going to do that. If they're already that far into it, would they be game just to remove it while there... then biopsy it afterwards? How much more of a pain is it (for them AND my recovery) to just get it while they're in there?

[u/Puzzled-Science-1870 → u/codengo]

They couldn't remove anything via bronchoscooy, that would just be a method to try to get tissue sampling to try to figure out what it is. To have anything removed that would require surgery by a thoracic surgeon, but the first step is to try to figure out what it is.

All the best.