Hi, Jessica Parks.

On February 5th, we performed a chest CT scan to look for signs of lung cancer.

Your report summary:

lung-diagram
worrisome nodule
benign nodule
benign nodule
benign nodule

Right

Left

Your exam result:

Follow-up imaging needed

We found one concerning nodule in your left lung, but we can't tell if it's cancerous from this test alone. We will need to perform another CT scan in three months to take a second look at this nodule.

1 low-risk nodule
3 benign nodules

Full Report

Reading complex medical jargon is our job, not yours. We converted your chest CT report into simplified language so you can understand the results, too.

The translations (shown in blue) are displayed along with the original report text below.

Tap any highlighted term to read about its meaning.

Full Report

Here is the original text of your chest CT report (don't worry, we aren't expecting you to decipher it yourself—that's our job).

Click on any highlighted term to read about its meaning.

Translation

We converted your report into simplified language so you can easily understand the results, too.

Indication: Z12.2 Encounter for screening for malignant neoplasm of respiratory organs, screening. Screening CT for detection of pulmonary nodules is requested.

The indication section states the reason why your doctor ordered this particular study. Often there will be diagnostic code information included in this section. The diagnostic code information may list symptoms or health conditions potentially related to the reasons why you and your doctor thought you needed the imaging study.

Comparison Exams: None

The comparison section lists any studies you had done in the past that we looked at to see if there were any changes.

Protocol: Contiguous 1.25 mm axial images were obtained from the neck base through the upper abdomen without IV contrast material using low dose technique. 5 mm axial, sagittal, and coronal reconstructions, as well as 3D maximal intensity projections (MIP) to facilitate nodule detection were also performed.

The protocol section describes the technical aspects of the scan. This scan was a computed tomography (CT) scan of the chest. This scan was performed to look for signs of lung cancer.

Findings:

This part of the report describes what the radiologist sees on your images. The radiologist will often comment on both normal and abnormal structures using specific, descriptive medical terms.

The visualized thyroid appears unremarkable.

Your thyroid gland is normal.

The heart, aorta, and main pulmonary artery are normal in size.

Your heart and the large vessels that take blood from the heart to the lungs (pulmonary artery) and the rest of the body (aorta) are normal in size.

Moderate three vessel coronary artery calcifications noted.

Coronary arteries supply the heart muscle with oxygen. Calcifications can lead to narrowing or obstruction of the vessels carrying blood to the heart muscle. Coronary artery calcification is a sign of coronary artery disease and may increase your future risk of a heart attack.

No pericardial effusion.

No fluid around the heart.

No mediastinal, hilar, or axillary lymphadenopathy. Multiple calcified mediastinal and right hilar lymph nodes are noted and likely sequela of prior granulomatous infection.

The lymph nodes in your chest and under your arms are normal in size. Some of the lymph nodes in your chest have calcification. This is a common finding and is often related to a prior infection that you may not have even known you had.

The central airways are patent.

The trachea (windpipe) is open.

Moderate, apical predominant centrilobular emphysematous changes are noted.

Your lungs show signs of emphysema. Emphysema is a lung disease that is most often caused by smoking. Smoking causes destruction of the air sacs of the lung. Emphysema can lead to symptoms such as shortness of breath or cough.

Multiple small nodules bilaterally.

You have small pulmonary nodules in both of your lungs. This is common in people your age.

Representative and largest irregular nodule in the left upper lobe (series 4, image 109) measures 8 mm.

suspicious solid nodule

The largest pulmonary nodule is located in the upper aspect of your left lung and measures 0.8 cm, slightly larger than a pea.

Additional smaller nodule in the left lower lobe (series 4, image 249) measures 4 mm.

benign solid nodule

There is a 0.4 cm pulmonary nodule which is in the lower aspect of your left lung.

Groundglass nodule in the right upper lobe (series 4, image 126) measures 4 mm.

benign groundglass nodule

There is a 0.4 cm groundglass pulmonary nodule in the upper aspect of your right lung.

Solid nodule in the right middle lobe (series 4, image 138) measures 4 mm. Multiple additional smaller nodules.

benign solid nodule

There is a 0.4 cm solid pulmonary nodule in the middle aspect of your right lung.

No pleural effusion.

No fluid around your lungs.

No pneumothorax.

Your lungs are not collapsed.

Limited evaluation the upper abdomen is unremarkable.

The upper part of your abdomen was partially seen on the images. The organs seen in your abdomen are normal.

No aggressive osseous lesions identified.

Your bones are normal.

Impression:

1. Solid nodule in the left upper lobe measuring 8 mm in maximum dimension, differential considerations include neoplasm, infection, and inflammation. There are also some smaller nodules as described above. Lung-RADS category 4A - Suspicious. Based upon nodule characteristics, additional testing is recommended: 3 month follow-up CT.

suspicious solid nodule

The largest pulmonary nodule in the upper aspect of your left lung is suspicious. In other words, we cannot tell if this pulmonary nodule is cancer or not. There is an 85-95% chance that this nodule is not cancer. To be 100% sure, we want to follow this pulmonary nodule closely. We recommend a follow-up CT scan 3 months from now.

2. Moderate centrilobular emphysema.

finding unrelated to cancer

There is evidence of damage to your lungs due to smoking. If you are still smoking, you should stop now before the lung damage becomes worse. If you have already quit smoking, congratulations! While your lungs will never return entirely to normal, you can prevent further damage by remaining smoke-free.

Learn more about Emphysema   

3. Moderate coronary artery calcifications.

finding unrelated to cancer

There is evidence of coronary artery disease, which places you at risk for heart attack. There are medications and lifestyle modifications you can make to minimize your risk. Talk to your doctor about these changes.

Learn more about Coronary Artery Disease   

ACR Lung-RADS Category and Recommendation*: 4AS (S modifier for presence of emphysema and coronary artery atherosclerosis)

The American College of Radiology (ACR) provides a classification system that your radiologist uses to determine your risk for lung cancer based upon the screening study findings.

Lung-RADS categories explained   

What's the next step?

You have a suspicious nodule that we would like to keep an eye on. Schedule a follow-up online or by phone below.

Schedule an appointment

Need more information?

We're available to talk if you have any questions or concerns about your scan.

Message your radiologist
Ryan Short

Ryan Short MD

Duke Radiology

919-100-2000