Should I be concerned with a report of "scattered pulmonary nodules" on a chest CT? they measure 2mm and are sub-pleural. Would they be visible on a chest x-ray? A repeat CT is recommended in six months.
Dr. Hays is a Pulmonary and Critical Care specialist whose main interest is in the evaluation and treatment of persons with advanced lung disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, and pulmonary fibrosis. In addition to his interest in state-of-the-art medical and surgical therapies for lung disease, Dr. Hays is also committed to prevention. Dr. Hays devotes time to education and programs related to smoking cessation as well as early identification of lung disease.
Thanks for your question. Pulmonary nodules found on a CT scan of the lungs can arise for a variety of reasons. Generally a clinical history and exam are helpful in narrowing down the possible causes. In a person with no previous history of cancer and no symptoms, multiple pulmonary nodules of small size (less than 1 cm) are most likely to be the result of benign processes such as old infections, scars, or lymph nodes. For example, people who live in the central U.S. frequently have small nodules that show up in CT scans as a result of previous histoplasmosis infection (a fungus common in the Midwest).
In cases where there is a low suspicion for active infection or malignancy, a follow up CT scan to assess for changes is often the recommended next step. If there are symptoms, such as cough or mucus production, an analysis of the mucus or further diagnostic testing such as bronchoscopy may be performed. If doctors suspect an active inflammatory process or a history of cancer then a lung biopsy will often be obtained.