Is "tree in bud " nodularity serious?

Posted by leilam @leilam, Jun 9, 2023

I was diagnosed with bronchiectasis many years ago but recently had sputum positive for Mac. Because of my age (86) my ID decided to just watch and not treat.
I had a CT scan last week and it came
back with a reading of " tree in bud" nodularity throughout the basilar segments right lower lobe. Everything else was normal except for calcified granuloma left long base which is not new. I just wondered if this is something I should be concerned about. I don't see my Pulmonologist until September.

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irene5 Irene Estes | @irene5 | Jun 21, 2023

In reply to @rchildress "Hi Sue. I couldn’t find where to post this question so thought you would know. If..." + (show)

I am presently MAC free. It has been in the right and then spread to the left. A have a rare azygos fissure which apparently slowed the spread of it. So yes MAC can spread to left and right lungs. It is very rude! irene5

Renee | @rchildress | Jun 21, 2023

In reply to @irene5 "I am presently MAC free. It has been in the right and then spread to the..." + (show)

Thank you for the information in MAC spreading to the other lung.
Today I went to the eye doctor and told him about what I had and my concern about the antibiotic that can cause eye problems so he looked it up and called me and said that if it did effect my eyesight it would do permanent damage to my eyes so I am not going to take that antibiotic even if they suggest it.
I am very irritated that I even got this.
How long did it take you to clear it up?

lucie0948 | @lucie0948 | Jun 22, 2023

My sister was 18 months into the Big 3 and her vision in one eye was greatly declining. She quit all three cold turkey. It took a few months, but her vision was completely restored. (btw - I too have MAC and am choosing not to go on meds. So far, so good, thank God).

kayskid | @kayskid | Jun 24, 2023

My MAC relapse cultures are positive for M avium and I have bronchiectasis w/tree and bud, etc. I am going to try to wait on tx, hoping I can prevent worsening CT scan. This time I don't feel too sick: very tired, little cough and afternoon chills. My new MD gave me the aerobika and I am following the directions but having a hard time bringing up much sputum. Trying to stay hydrated. We are trying to move to senior community and I am caregiver for my husband who has Parkinsons. Very stressful! It is so hard to take care of myself with this workload and I think the stress is going to make this infection worse. Sorry to complain.....

kayskid | @kayskid | Jun 25, 2023

In reply to @kayskid "My MAC relapse cultures are positive for M avium and I have bronchiectasis w/tree and bud,..." + (show)

Thanks for the virtual hugs!

sylvermoon8 | @sylvermoon8 | Jul 8, 2023

In reply to @sueinmn "Yes, I did for 18 months due to the severity of my infection. After learning on..." + (show)

Is there an explanation here what sputum testing is? All I saw online was that you cough up sputum, but I rarely cough up anything. My pulmonary doctor went right to a lung biopsy back in 2019 when I was first diagnosed. I recently had a CT that showed a new small area of concern and I will have a repeat CT in 6 months and if no improvement with the Aerobika then she wants to do another biopsy.

sinojosvacios | @sinojosvacios | Mar 3 11:55am

In reply to @sueinmn "Here is a basic guide. https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/bronchiectasis MAC/MAI/NTM (all similar) can come with or without bronchiectasis. It..." + (show)

I have a positive ANA and positive autoantibodies for antisynthetase syndrome although I do not have ILD. Have you heard of people specifically testing positive for this? I wonder if it's because the PL-12 autoantibody is a reflection of a general lung issue.

Sue, Volunteer Mentor | @sueinmn | Mar 3 12:49pm

In reply to @sinojosvacios "I have a positive ANA and positive autoantibodies for antisynthetase syndrome although I do not have..." + (show)

Hello and welcome to Mayo Connect. We are not professionals here, and your question is way outside of my experience or knowledge.
Have you discussed these test results with your pulmonologist?
Sue

endrick | @endrick | Mar 4 5:00pm

My recent CT scan showed…Branching nodule conforming to the shape of an airway in the left upper lobe measures up to 2.1 cm in maximum dimension There are associated distal tree-in-bud nodules There is no associated cavitation. There is no bronchiectasis. Additional, smaller cluster of distal impacted airways with associated tree-in-bud nodules are present more superiorly in the left upper lobe. I didn’t have any of this in my CT scan 6 months ago…. Safe to assume this is very fast growing …thoughts? Seems odd to just show up I had the CT scan to follow up on a lung nodule that has since resolved itself but now the CT showed the above… all seems so strange. My mom has lung cancer that was in remission but now back…never any of this terminology before.

Sue, Volunteer Mentor | @sueinmn | Mar 4 9:13pm

In reply to @endrick "My recent CT scan showed…Branching nodule conforming to the shape of an airway in the left..." + (show)

What led to the current CT scan? This is not normal day-to-day lab work, so there must be a reason?
Also, most pulmonologists aren't very concerned about small nodules - less than 7-8 cm unless there is underlying illness. What does the pulmonologist say?
Sue

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