Q. Is it normal for a lesion to appear in different sizes in the CT scan reports taken two hours apart?
Hello doctor,
As a result of recent intermittent chest pain, I have had two chest CT scans with contrast done within two days of each other. The first CT done at my cardiologist’s office was to measure my calcium score but noted a nonspecific ill-defined approximately 2 cm patch of ground glass with predominant right upper lobe attenuation present. The second CT scan, two days later, was done at a hospital and reported a ground glass lesion in the anterior right upper lobe measuring approximately 6 mm. More inferiorly, the ground glass lesion in the anterior right mid lung measures approximately 10 mm in anteroposterior extent. My calcium score was very low, and blood test results came slightly elevated for WBC, but otherwise good. My questions are regarding the ground glass lesion. I was told the body would likely absorb them and disappear. However, as the two reports differ in quantity and size of the ground glass, I am very worried. I was never a serious smoker but smoked on occasion about 30 years ago. If these nodules are nothing serious, how long would it take for them to disappear and be absorbed by my body? Is there any relevance to the reports being so different in quantity and size of the ground glass? I plan to consult with a doctor and know these have to be tracked. But is surgical removal an option? Please provide any information on these findings and questions.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I have gone through the detailed history you have mentioned. First of all, the difference in size is huge in two different CT (computed tomography) scans, which are two days apart. Usually, this is not possible. Secondly, ground glass opacities are commonly seen with infection, inflammation, and allergies. The earliest symptom would be dry cough which is absent in your case. So it will be of great help if you can send me images of the CT scans. Also, let me know.
- Do you have allergies?
- Do you have a fever or dry cough?
- Have you taken any medication after the first CT?
Please reply me with answers so that I can guide you better.
Thank you and take care.
Hello doctor,
Thank you for the reply.
I currently do not have the CT images. I do not have any allergies, fever, or dry cough. After the first CT scan, I took my usual medications of tablets Keppra and Ambien. Do you think the difference in size over just two days could be a radiologist error or different imaging centers' techniques? When would I expect these to no longer appear if they are not serious?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Usually, the error difference by machines or radiologists is very small, like 2 mm to 3 mm. But in your case, the difference is more than 5 cm. Can I see printed reports of both CT (computed tomography) scans?
And 2 mm ground glass opacity without any symptoms is not problematic. But 6 cm ground glass opacity should be evaluated. The usual regression time is two to three weeks, but we must first find out the cause. If possible, please send me your CT reports.
Thank you and take care.
Hello doctor,
Thank you for the reply.
I have attached the CT scan reports. Please inspect them and kindly suggest.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
I have reviewed both CT reports (attachments removed to protect the patient's identity). The first report shows larger ground glass opacity with evidence of pulmonary embolism. The second CT is not showing any evidence of pulmonary embolism, and the size of the ground glass is also reduced. So the possibility of disappearing pulmonary embolism and related improvement in ground glass opacities is more likely. And please let me know.
1. Did your chest pain reduce after the first CT scan?
2. What was the exact location of chest pain?
Revert with answers.
Thank you and take care.
Hello doctor,
Thank you for the reply.
Yes, doctor, the second CT shows a reduced size but an additional lesion. Chest pain has been intermittent for over two weeks but has not been severe. The location of the pain is the top right.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Regarding the lesion, I still believe it is due to resolving pulmonary embolism.
- Is the pain still persistent with the same intensity as the first CT?
- Have you consulted with any doctor or pulmonologist after the first CT?
- Any history of similar chest pain went uninvestigated?
- When is your next appointment with a pulmonologist or another doctor?
Revert with the answers.
Thank you and take care.
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