Is "tree in bud " nodularity serious?

I had a CT scan 6 months ago for a GI issue and a 8mm nodule was an incidental finding on that CT. This was the 6 month follow up. That nodule (right lobe) is gone but now this on my left lung. My PCP ordered this CT. The GI ordered the original and sent me back to my PCP for follow up. I haven’t seen a pulmonologist but wondering if I should

I had a CT scan 6 months ago for a GI issue and a 8mm nodule was an incidental finding on that CT. This was the 6 month follow up. That nodule (right lobe) is gone but now this on my left lung. My PCP ordered this CT. The GI ordered the original and sent me back to my PCP for follow up. I haven’t seen a pulmonologist but wondering if I should Also I thought nodules less than 8mm were considered small?

Maybe ask your PCP if there is cause for concern? They will look at your medical history and all of your risk factors in making the decision. If I was without symptoms and not high-risk (not a smoker, no COPD, etc) I would ask if repeating in a year is a reasonable option.

One more thought - have you had Covid or pneumonia in the past year? People often have "artifacts" in their lungs - opacities, nodules, etc after an infection. Most resolve themselves within 6 months to a year.

Sue

My pulmonologist at Penn’s Bronchiectasis Clinic made a couple of interesting comments about this type of CT findings.

I’d had 2 CT’s read by 2 local radiologist (not Penn) and 1 at Mayo last March, all showing ground glass, mucus plugging, trees-in-bud and atelectasis with clearing of some, but some new areas. Second CT showed mild bronchiectasis had developed. All 3 radiologists commented that findings were consistent with NTM/MAC. Last March, Mayo did bronch, got a good specimen and it showed no MAC or other pathogens. I have very little sputum from lungs.

I asked my Penn doc about the radiologists’ comments about MAC, ground glass, mucus plugs, etc. with my inability to produce mucus. He said radiologists like to add the comment about MAC because it’s specific and might be helpful. He said I probably can’t expectorate sputum because little is there. He thinks it’s possible I’ve had MAC and cleared it and said CT findings can be very persistent and sometimes remain.
The other theory is that it’s all related to my persistent sinusitis.

My f/u CT is next week. We’ll find out if my airway clearance efforts are working and if that recent weird culture was significant.

Glad MAC was not a found in you this go around. I'm curious how you manage your chronic sinusitis, which I know is off topic!

I just read your post.
Hope you are doing well and that you are having some help with it all....like the senior community you mentioned. You have a lot on your plate to take care of and do considering what you mentioned in your post and the health of you both.
Stress , especially unrelenting stress, sure does not help before one ever has a diagnosis of a health condition and may be the cause of many illnesses. It sure doesn't help especially after the diagnosis.
I understand STRESS I had much unrelenting stress for many years and consider it as one of the possible causes of my BE, my opinion. No MAC as yet.
Hope you are 'managing'...that's my answer when people ask "How are you doing?"

Thanks for your thoughtful response. I have not posted in a long time. My update is that my stress level exploded these past six months with a death in the family, a move and my husband's steady decline. In Dec, I got COVID and was very sick. My lungs were on fire but I could not leave my husband to get care for myself. In January he had a steep physical and cognitive decline and he was hospitalized. I was told that his care needs were beyond what I would be able to manage and he was admitted to LTC. At first, I thought that the COVID had severely damaged my lungs. I was short of breath and coughing and couldn't sleep. Now, the stress is resolving. My MAC seems better. I will have a CT scan in April. I would like to hear from others who have had COVID with MAC. I am glad to be back to reading your posts. All the best to you all.

I currently use the following for my sinuses:
1. “Triple spray”compounded at Mayo’s pharmacy with Mometasone, Ipratropium and diphenhydramine. I called them last week and they will accept an order from my Penn pulmonologist. It doesn’t leave a bad taste like Azelastine and I THINK it works better.

2 . Ipratropium spray mid afternoon. The duration of action is about 6 hrs so dose in triple spray wears off. I’d been prescribed Atrovent a few times when I lived in another state and it seemed better for me than Flonase.
3. Mometazone (compounded by local pharmacy) in 8 oz saline via sinus rinse bottle twice daily. Note-this was started by Penn frontal sinus doc last May for my hoarseness from significant secretions despite 2x daily saline rinses and allergy meds. I’ve stopped this steroid a few times. I had trouble with thrush at first. I also stop this steroid when I’m sick, but continue saline rinses.
4. Cetirizine in morning. I’m not sure it helps, but pulmonologist suggested I try it again.
5 Benadryl or doxylyamine at night.

The regular ENT guy does Rhinair, a laser procedure to decrease PND, but the Penn specialist he referred me to for frontal sinus didn’t mention it. I may ask Penn their opinion if the upcoming allergy season is tough. Has it been mentioned to you?

I asked for allergy testing and ENT did it. . It was helpful to know the triggers. Have you had that? ENT or allergist?

If you have suggestions, I’d love to hear them. Until the saga of the last 3 years, I’d had just one or two acute sinus infections a year since surgery 20 years ago.