CT Scan of Chest without contrast

[anxiouslywaiting683]

I am a 30/year old male with history of smoking in my background. I had pain start on my left side chest wall extending to my back and my doctor, prescribed I get an X-Ray, the X-ray came back clear. I was still in pain 2 weeks later and I demanded a CT Scan or further eval ( I had no history of trauma). I went for a CT scan last week and my report states:

"Mild Infiltration of the subcutaneous tissue in the left lower lateral chest wall, consistent with Hemorrhage or edema and sub threshold sized lymph nodes; no masses or tumor"

"2.7mm x 3.7mm non-calcified granuloma on right lower lobe"

What does this mean, what is mild infiltration, I asked the doctor and he couldn't really give me an answer. He said it could be anything, but didn't really offer anything or suggest any further testing.

[anxiouslywaiting683]

Thanks for your response, however will this still be the case if I have no bruising on the skin? Extreme tenderness and pain even when standing/sitting and some swelling but no bruises; does tietze syndrome sound like something, it's not in the middle of the chest but rather 2 ribs below my chest/breast closer to my side.  I spoke with my doctor and he mentioned the same thing you did however I woke with this pain. He ran an ESR(?) and it came back with a number of 45. He said the pain and or swelling should've subsided by now and I am pretty worried.

[David Tinkelman, M.D.]

The description you have provided of the chest pain and the CT scan finding of “infiltration” of the subcutaneous tissue of the chest wall is consistent with chest wall pain secondary to trauma with bleeding into the tissues of the chest wall.  The trauma need not have been dramatic or even overt but just sufficient to cause soft tissue bleeding.  Infiltration of any anatomic structure, in this instance the soft tissue of your chest wall merely means the presence of body tissue or fluid in tissue, where it is not supposed to be.  For example, with a bruise characterized by swelling and discoloration, blood and serum has infiltrated the soft tissue.

In most instances, such infiltration will, over time, be re-absorbed and the tissue revert to its natural state.

Check with one of your other doctors about this, or with the radiologist, to get their opinion of the nature of the infiltrating, biologic substances.

Good luck.