Lung nodule/ different doctor responses leaving me confused!

[beth1162]

I am a 51 year old woman.  I was in the ER for a heart fibrillation issue when the doctor discovered a 2.5cm "spot" in my lower right lung via Xray.  I then had a CT scan of my heart...not sure if the spot was examined on that CT scan.  He stated that I had pneumonia (I thought I had the flu), but he also ordered a blood test for TB to rule TB out (test was negative for TB).  I was started on antibiotics immediately.  I was then transferred to another hospital the next day (due to insurance) where I met a different pulmonologist.  He immediately started the conversation by saying that I might have lung cancer and we should schedule a lung biopsy right away even though he admitted he had yet to see the Xray (he based his decision on reading my chart).  I wasn't even worried about lung cancer after the first doctor told me I had pneumonia!  I told this doctor what the first doctor had said about pneumonia and TB and he then scoffed at the idea of having TB as TB is rare in our area.  I made no commitment to having a biopsy at that time.

The next day, a different pulmonologist comes in and asks what I have decided about my lung.  I told him I was very confused and shared what I had been told by the first two doctors.  I told him that I have never smoked nor lived in a smoking household.  I stated that I know nonsmokers can get lung cancer, but I thought the chances were lower.  I also said that I did not understand why we could not wait a week or two and take another Xray to see if there were changes...to see if the spot was the pneumonia.  He quickly said that pneumonia takes a good 6 weeks to clear from your lungs and I should get another lung picture in 6 weeks.  He did not seemed concerned at all about cancer.  Or at least he did not say he was.

The final doctor I saw was the regular MD who released me from the hospital.  He told me he thought the 6 week recheck was a good plan, but he also stated that the spot was "worrisome."  I have a consult appointment to see yet a different pulmonologist in exactly two weeks.  At that point, I am hoping to get some answers about exactly what kind of spot it is (never got any details).

Obviously, there was something about the spot that made the first doctor think it might be TB.  I am wondering if anyone knows what makes a spot look like TB?  Do TB and pneumonia look the same?  Is a pneumonia spot or TB spot easily confused with a cancer mass?

I find it truly frightening that these doctors were all over the place with a diagnosis!  So here I sit worrying, waiting and praying that it was just pneumonia and the spot will be gone in the next Xray or CT scan.

[beth1162]

Thank you for your reply.
At this point, I am still waiting and worrying.

[Paderla Anitha, DNB]

Hi, understand your predicament. But from imaging studies alone, it is difficult to make an exact diagnosis. It can only be differential. Tuberculosis heals by fibrosis. But an acute infection can cause a pneumonic patch. So, you will only have to wait and watch, if it does not resolve after six weeks, you may need a biopsy. A biopsy facilitates a histologic study of cells, which gives you a definite diagnosis. So once you have the diagnosis you will know what measures or precautions you need to follow. Good Luck.