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Q. Does my chest x-ray show any nodules of concern?

Answered by
Dr. Vivek Chail
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 20, 2017

Hello doctor,

I am looking for a second opinion regarding my chest x-ray. The chest x-ray showed no masses, nodules or pneumonia. I just have a very mild inflammation and an old rib injury. The doctor told me that I had heart deformities, but I already knew about those.

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#

Hello,

Welcome to icliniq.com.

I have seen your x-ray reports (attachment removed to protect patient identity).

  • There appears to be a mild prominence of the bronchovascular markings in both the lungs, more so in the lower lobes. This is not a serious problem and sometimes can occur without any accompanying symptoms. In most people, this happens when they get the flu or a dust allergy.
  • Why did you get the chest x-ray done? The old fracture is probably the one in the left fourth rib posteriorly.

Revert with more information to a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist

Hello doctor,

Thanks for replying. I got the x-ray done because I have been having pain on breathing. Two years ago, I had a mole removed that was borderline for melanoma, but I was assured by two pathologists that it was still benign. So, I am paranoid in that regard. Do you see anything with regards to nodules or masses? The report said 'no suspicious nodules,' which made me wonder if he saw benign ones or if that is just the language radiologists use. They suspected a pulmonary embolism and did a D-dimer test, which I am waiting on.

#

Hello,

Welcome back to icliniq.com.

  • There are no nodules or masses on the chest x-ray.
  • However, the chest CT scan is a detailed investigation, and if anything comes up in the D-dimer or your lung function tests, then a thorough investigation is required. Please note that a CT scan is not recommended unless your doctor feels the necessity right now.

For more information consult a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist

Hello doctor,

Thank you for replying. The D-dimer test was negative. So, they recommended nothing further and chalked it up to pleurisy. Can you compare my most recent chest x-ray with the one I had three years prior? I am just curious if there are any changes. I have no idea how to read an x-ray, but the most recent one looks more congested to me. I am also wondering if weight difference alters the appearance of x-rays.

#

Hello,

Welcome back to icliniq.com.

  • I compared the x-ray you sent earlier with those taken three years ago (attachment removed to protect patient identity), and I find that the right hilar and para-cardiac region is slightly denser and that is what you refer to as congested.
  • There can be two reasons for it to appear that way:
  1. The brightness adjustments of both the x-rays are slightly different.
  2. Fine lung inflammatory changes in that area.
  • Get a CT scan of the chest done for screening.

For more information consult a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist

Hello doctor,

Thanks for replying. Could the lung inflammatory changes be from a simple cold? Are you sure the changes are not nodules? Could they be related to pulmonary hypertension? My last heart catheterization showed I had the early stages of that.

#

Hello,

Welcome back to icliniq.com.

  • The inflammatory changes can be due to the following reasons:
  1. Dust allergy.
  2. Flu.
  3. Wheezing, in the case of asthma patients.
  4. Secondary to your heart condition and pulmonary hypertension.
  5. Mild diffuse lung conditions.
  • Therefore, the findings have to be matched with your symptoms. I do not see any nodules, big or small, in your x-ray.

For more information consult a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist

Hello doctor,

Thank you for replying. My doctor recommended nothing further at this time and said I likely have some bronchitis or a cold. I do not know if I feel like I have a cold, but I definitely have a sinus drainage and a sore throat. My biggest concern, whenever I get an x-ray, is cancer, though I am not at risk and only paranoid. But in your opinion, is that a concern? I also recently had a cardiac MRI, which said my heart was functioning fine. So, I am not too worried about pulmonary hypertension. When you recommended a scan, was that to screen for pulmonary embolisms?

#

Hello,

Welcome back to icliniq.com.

  • The reason I suggested the scan was to screen the lung for any small airway inflammatory changes.
  • You can attend an annual cancer screening in your city to avoid the thoughts of cancer.

For more information consult a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist

Thank you doctor,

So, given the x-ray, and the fact that my symptoms are abating, do you agree with my doctor's recommendations to let things be?

#

Hello,

Welcome back to icliniq.com.

  • Yes, as long as you do not have any persisting breathlessness or a cough, you do not require any further investigations.
  • You can get a lung function test done if symptoms reappear. And if the results are suspicious for any small airway condition, then a chest CT can be done.

For more information consult a radiologist online --> https://www.icliniq.com/ask-a-doctor-online/radiologist


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