Incidental lower lung module found

why cant pulmonologist look at that scan.

She said they have sent things back to PCP for more info. She said they would need a lung CT w/O contrast. I don’t know if the contrast from the abdominal CT affects how things look or not. the radiologist could have left any less info on the report, so I’m at a loss. And it doesn’t help things being right here around the holidays.

@pitts30 When CT scans are performed on one body part, and there is what is known as an "incidental finding" in another organ, it often comes as a shock. Please take a deep breath and consider this.

One lung scan could miss a very small 4mm (just over 1/4") nodule if there was any congestion or if it was hidden by other artifacts in the scan, where another, possibly if you are positioned differently would see it.
Subpleural nodules are outside the lung itself, between the 2 layers of the pleura, the membrane that covers and protects the lungs. Not being a radiologist, I don't know if they are harder to see, but the good news is "outside the lung"

Many people have nodules that are benign, I had several when I had a bad lung infection. It was treated, and now they are gone. Here's where "Dr Google" fails us - without context, the worst possible outcomes and the most usual ones are all jumbled together. Because we are already worried, our minds just jump to a dark place.

A thorough pulmonologist would probably want a new scan, possibly with contrast dye, to get the best and clearest possible view of the entire area. Then, he would compare it with the first two, evaluate it in light of your health history, and with his knowledge of what are typically benign nodules, and which are threats.

The most common approach, if it looks benign and has not grown since the previous scan, is "watch and wait", possibly repeating the CT in 6 months or one year. But, if after a further look, the pulmonologist thinks it looks suspicious, they would probably refer you to an oncologist for further testing (PET scan, biopsy). That still doesn't always mean you have cancer, but if it is determined that you do, this doc will come up with a treatment plan.

I hope this little bit of information helps you breathe more easily as you make an appointment with the pulmonologist. And please remember, that all your friends and family will have their own opinions and stories - listening to them will not bring you peace of mind, so ask them to save their advice until after you consult with the doctor.

And when your [neighbor, coworker, brother-in-law] tells you "...you don't need another scan, that's just their way of [padding the bill, ripping you off]!" Smile and ask "Oh, where did you get your medical degree?"

Good luck - we're here to help you get through this.

I guess one of my many concerns would be if there isn’t any directions to the new test than due to position or how the scan is done. Then the results will likely be the same as the first and not show anything. So it a good/not terrible that it’s outside the lung? Sorry for the dumb questions this is all new to me and has my anxiety high. Thanks

The new pulmo, in his CT order to Radiology, will tell them what they are looking for.
And yes, it is my understanding that small nodules in the pleural cavity are most often benign.
Feel free to small the questions you want, many of us have been at those anxious crossroads like you.

I think "subpleural" means inside the lung, but close to the pleura.

I usually get a report from a radiologist at the CT-center, but only
maybe after a 10min look at it.
The PCP won't look at it and the pulmologist usually has not much time
and is not specialized in CT-interpretation.

IMO , when it's complicated they should submit it to a national or international
center with a big database and experts for different subspecialities

Pulmonologist will not even schedule me at this time. They have sent things back to PCP to get them the scans they needs. But the PCP is the one that ordered the original chest. So I’m afraid if pulmonologists doesn’t direct imaging that we are just going to get the same results. I’m not trying to be negative. I just feel like I’m stuck. I just wish pulmonary would have just taken a look and then ordered what they wanted and left PCP out of it.

yes exactly, I had my report in less than an hour after the scan. So I know there wasn’t much time taken on it. I see all these other reports and everyone’s states shapes and density or calcification and recommendations for follow up . PCP hasn’t look at anything other than the report, and there is t much there other than location and size. Is it possible for me to send my scan to another radiologist or teaching hospital for a better interpretation. I’m just kinda lost at the moment.

I once found "National Diagnostic Imaging" which looked good,
but it\s no government organisation, as I first thought.
Then I found some compenies in India which cooperate with
US-hospitals for quick 2nd radiological opinions.
Usually only for some specialities, e.g. Thorax-CT

I myself =after much search- finally found a radiologist in Berlin
for a 2nd tele-opinion
on CT wrt. interstitional lung disease.

It would certainly be worth calling a few pulmonologists and asking for a consult, citing the two CT scans with different findings.

I agree that going back to the PCP seems like an unnecessary step UNLESS the Pulmonologist told the PCP exactly what they need.