3 to 4 mm nodular densities

[bellamia21]

I recently had a Chest x-ray that shows there are small 3 to 4mm nodular densities projected @ both upper lobes.
I have a noncontrast chest ct scheduled. Can you please tell me what the nodular densities are and what the route of treatment is. Also what would cause these.. Very nervous.
Thank you for your time

[Fernando Roque, MD]

Hi.  Scarring from a previous chest infection does not always result in calcification.  It is quite possible that the nodular density is just a scar from that event. Since you have a prior history of cancer, we cannot completely discount the possibility that the nodule may signify cancer recurrence.  Ideally, the nodule should be biopsied, but it may be too small for biopsy to be done accurately.  I agree with the plan to repeat the chest CT after three months.  If the nodule has not changed on repeat CT, then it's most probably a scar and doesn't need to be biopsied.  If it has grown bigger, then a biopsy should be done to investigate it further.

[gsp53]

I had a routine CT  scan which showed a 4mm non-calcified nodular density in the bottom of my left lung. A standard chest X ray showed nothing. I am to have a thoracic CT scan in 3 months. I had bladder cancer (low grade) 2 years ago. I had a mega chest infection in January - if there was scarring or residual infection would this have calcified by now ? I am not sure at all what to think about this and the absence of a specialist to  discuss this with does not help.

[Fernando Roque, MD]

Hi.  Those densities could represent an ongoing infection (e.g. tuberculosis) or scarring from a previous infection.  Amyloidosis, a condition where there is an abnormal accumulation of protein (amyloid) in various organs, may also present as nodular densities in the lungs.  Finally, those nodules may mean the presence of malignancy. With only a chest x-ray, we cannot be certain what those densities are.  Other tests need to be done, and a chest CT is a step in the right direction. A biopsy of those nodules may also be considered.  Treatment will depend on what the underlying condition is.