Can someone help me interpret these CD Results?

[Paula Sims]

I know you're not a doctor (officially in this capacity on the DU) but any insights would be appreciated:

Background - I'm 52, never smoked, never drank, but my parent did and coworkers smoked around my cube for 5 years when it was allowed. I've had various version of bronchitis & pneumonia, once perhaps whooping cough. I also had a rectal carcinoid but that was benign. I have an appt with a pulimologist on 6/20 (thanks to the wonderful-you don't have to wait for your doctor American -- medical care) so any insights (which I won't hold you to) is helpful.

Yea, I'm terrified. . .

Thanks

/******************************************************************************************?

FINDINGS:

The exam is of generally adequate diagnostic quality, without evidence of pulmonary embolism to in most cases to at least the subsegmental pulmonary artery branch level. Ascending thoracic aorta is grossly nonaneurysmal. No substantial appreciable
coronary artery calcifications or pericardial effusion.

No pleural effusion. Subtle mosaic attenuation of the lung parenchyma, more so in the bilateral lower lobes, raises the possibility of subtle air trapping. Central airways are grossly patent. Mild lower lobe predominant peribronchial thickening. A few 4
mm or less noncalcified pulmonary nodules in the lung bases are stable from at least 8/13/2010 indicative of a nonaggressive process, including in the right lower lobe (axial 80) and left lower lobe (axial 93). Other scattered pulmonary nodules were not
definitively imaged previously, including a dominant 6 mm right upper lobe nodule near the level of the minor fissure (axial 53) and less than 4 mm nodules in the right upper lobe (axial 54), middle lobe (axial 65) and right lower lobe (axial 74, 79).
Additional probable calcified granuloma in the right lower lobe.

No substantial appreciable thoracic lymph node enlargement. Generalized low attenuation of the hepatic parenchyma suggesting a component of probable steatosis. A few minimally prominent upper abdominal lymph nodes, including a 12 mm periportal lymph
node, are nonspecific but generally stable. The spleen is mildly enlarged, measuring 13.6 cm in craniocaudal dimension. Mild exaggerated thoracic kyphosis with subtle anterior vertebral body wedging and preferential osteophyte formation and disc space
loss in the mid to lower thoracic spine.


IMPRESSION:
1. No convincing acute pulmonary embolism.

2. A few lower lobe pulmonary nodules are stable dating back to 2010 indicative of a nonaggressive etiology. Other pulmonary nodules were not previously imaged and remain indeterminate, the largest measuring up to 6 mm. Fleischner guidelines recommend
followup CT in 3-6 months. Depending on risk factors and outcome of the initial followup CT, would consider additional followup CT in 18-24 months.

3. Subtle mosaic attenuation of the lung parenchyma, more so in the bilateral lower lobes, raising the possibility of subtle air trapping. Mild lower lobe predominant peribronchial thickening.

[sharp_stick]

1. It's difficult to tell just from this

but on a quick read it doesn't look bad. Nodules of less than 20 mm are generally (~90% of the time I think) benign and are usually caused by inflammation due to infection. Follow ups are indicated because some of them are new.

Mosaic attenuation is a radiology term meaning that the CT scan showed differing opacity. Air trapping can be indicative of bronchitis or bronchiolitis

[Heddi]

2. Why don't you ask your doctor

Instead of strangers on the Internet who most likely have no medical knowledge and certainly havent got information regarding your health history, etc.

[MineralMan]

3. The poster already said that there was an appointment with a pulmonologist

scheduled, so I assume questions will be asked then.

The previous reply was useful and should be helpful to the poster. Personally, I do not answer such questions, but others who do have knowledge might. Since there is no rule on DU regarding such questions, people will continue to ask them. Your advice is good, but the poster already acknowledge that an appointment is upcoming.

[Heddi]

4. Look, I'm an RN

What happens if someone says oh yeah that's totally awful? Looks like cancer . pretty awful prognosis, you should call the family to give you goodbyes. What then? Does she freak out? What if it's a troll or someone who just googled? I can read the report and give my opinion but I value my licenses as should anyone else who is licensed in any medical capacity. That means anyone who reads this report and gives their opinion 1) isn't a licensed medical professional, and therefore their "reading" should be taken with a grain of salt or 2) they are licensed and have no appreciation for the ethical considerations of giving anonymous reads to someone online, and the fallout of that reading and shouldn't be trusted.

But please, encourage everyone to get their medical advice from strangers on the Internet. Also, you don't need to remind me of DU rules, as I've been a member since 2001, which is just a spell longet than you have.

[MineralMan]

5. Oh, dear. I've been discouraging people from asking for or giving medical advice

on DU for years now. Go look at the pinned posts in the Health forum, if you don't believe me.

However, people have never paid attention to that discouragement and the questions keep coming. At least what was said in this thread is reasonably accurate and isn't likely to cause alarm. However, someone will, no doubt step in with health advice anytime now, probably of the idiotic type that makes no sense.

As I said, your advice was the right advice. I merely pointed out that the original poster already said that an appointment with a pulmonologist was scheduled. I'm sure that person will provide a good explanation. People do worry, though, when they don't understand such radiology reports. So, they come here and ask. I think that's a bad idea. I always have, but I try not to take it out on the person writing the question if they're already going to see a doctor.

[Paula Sims]

6. Thank you Heddi - appreciate your perspective. . .

I'm scared and asking my doc didn't help -- all he said was "it's nothing" but the pulminologist has to rule out things. Great. Going there in a month. And even then I'll be told to wait. I've a carcinoid survivor so that's never our of my realm of possibilities.

Until then, knowing what I'm dealing with and being prepared is how I've dealt with it.

I know DU isn't for medical diagnoses but just opinions - and those I find comforting. As well as your warnings.

Thank you.

Paula

[Heddi]

8. I get it, trust me...

I nearly had an anxiety attack when they called me back in for a repeat spot film on one breast after my first mammogram last year. I *know* they routinely do that because there's nothing to compare it to (meaning, no previous mammos) and I *know* that even the slightest movement or shadowing on the film can require them to want another one. But omg...when they called me the next day to have me come in, I was freaking out. I sent a copy of the mammo to my husband's docs (Mr. Heddi is an RN and works in interventional radiology) to look over...even though my own PCP is like "it's okay...it's normal...don't freak out." Yeah, easier said that done.

I *totally* get where you're coming from. I am just so...hypervigilant (?) about online diagnoses. You have to really prepare yourself for getting 1) innocent, but wrong information 2) malicious, but wrong information 3) possibly dreadful information that may be correct or incorrect. A bad diagnosis has to be given in a certain way. I have unfortunately a few times in my career inadvertently given patients horrible news thinking that their provider had already told them about cancer, or hepatitis, or whatever. I now make sure to ask the doc if the patient is aware of their condition/prognosis/diagnosis before I speak with them about it. If we're unsure, then the Doc has the conversation with them.

Take a deep breath, call the pulmonologists office and see if you can get your appointment moved up. Call your PCP (or whomever) called you and said 'nothing to worry about' and ask them to explain that to you. What is it that they're seeing. If it's nothing to worry about, then what are the nodules and why are they in your lungs. Is it nothing to worry about now, or ever? Is there a chance that this will progress to something else. Ask them the questions you have. You shouldn't have to make an appointment, the MD or their RN should be able to answer these questions over the telephone. Explain that reading this makes you anxious and you'd just like a bit of peace of mind before you see the pulmonologist.

[nolabear]

7. I absolutely understand your worry. But you need to get dx from someone who knows your case.

The internet will convince you of all kinds of things that aren't true. I google things too, but I'm a therapist and I can state with all kinds of conviction that if I paid too much attention to what I read online I'd think I deserved to be inpatient.

Hang on. I'm sorry you're going through such worries.

[Heddi]

10. Totally! I'm a Nurse

and google has me convinced that every ache I have is some growing, yet undetectable cancer.

[nolabear]

11. LOL! It's like having millions of busybody neighbors.

[Heddi]

12. I made the mistake of googling my dog's ear infection before I could get him to the vet

and so now not only is my body riddled with silently growing yet undetectable cancers but so is my dogs, and probably my fish too.

[yardwork]

9. If you are terrified, that alone is a medical reason to talk with your doctor.

Call the nurse and tell him/her that you are terrified and need to talk with your doctor sooner than a month from now.

Being terrified is not ok. Be well.