Your exam result:
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.
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 visualizedappears 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.
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.
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.
There is a 0.4 cm pulmonary nodule which is in the lower aspect of your left lung.
nodule in the right upper lobe (series 4, image 126) measures 4 mm.
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.
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.
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.
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.
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.
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.
3. Moderate coronary artery calcifications.
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.
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.
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.
Need more information?
We're available to talk if you have any questions or concerns about your scan.
Ryan Short MD