Q. Please see my CT scan, and let me know if I have lung cancer.

Answered by
Dr. Sunil Kumar Nookala
and medically reviewed by iCliniq medical review team.
Published on Sep 06, 2017 and last reviewed on: Sep 07, 2019

Hi doctor,

My CT scan says defined streaky opacity with associated loss volume and clustered tree in bud nodules have developed in the anterior segment of the upper left lobe. The associated central bronchi are impacted. Without an obvious mass, although a small central lesion is not excluded. The impression at the end said a focus of bronchitis and bronchiolitis with airway impaction has developed in the anterior segment of the left upper lobe. An infectious etiology is suspected, but a small endobronchial lesion could be obstructing, this is not a typical site for aspiration. Follow-up is recommended to confirm resolution.

I am of course concerned about lung cancer, but my pulmonologist said this mass looks like pneumonia, but the airway leading to pneumonia cannot be seen well. That is where the bronchoscopy comes in, as the airway cannot be completely visualized on a CT scan. If there were to be any abnormality in the airway, it would be more along the spectrum of a benign growth than lung cancer. Does this make sense? Do you agree?

Dr. Sunil Kumar Nookala

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine
#

Hello,

Welcome to icliniq.com.

  • Tree in bud appearance generally favors an infection. Can you upload your CT scan so that it may help? Do not bother about lung cancer.

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

Hi doctor,

Thank you for replying. I do not have the CT scans, but they did a bronchoscopy. Everything looked fine, however, the airway is small and in a tough location so they could only get two-third up the airway, and then took a biopsy from the last one-third. They said they saw streaks of blood near there. The swabs they took came back fine, the only comment was some white blood cells are present. However, the pathologist says that he needs more time on the biopsy, but he did not say why. I am flipping out now that I have lung cancer and that is his delay. I am 46 years old, and I have three kids. I am flipping out, please advise.

Dr. Sunil Kumar Nookala

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine
#

Hi,

Welcome back to icliniq.com.

Do not panic.

  • It is common to have some bleed in the bronchus. Generally, pathologist requires at least a week to report a biopsy. Maybe it takes more time in your country.
  • With your symptoms and your reports till now, it being cancer is very unlikely.

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

Hi doctor,

Thank you for replying. I am still having some blood in my spit, and some wheezing, which is more like stridor. My doctor said a while ago if there was an obstruction in the airway, it would very likely be more of a benign growth than lung cancer. Do you agree? Why would it be more likely to be a benign growth than a cancerous lesion? Thanks.

Dr. Sunil Kumar Nookala

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine
#

Hello,

Welcome back to icliniq.com.

  • It is common to have post-bronchoscopy hemoptysis.
  • Secondly, there is no clear cut opacity in your CT scan, which suggest that it could be an infection rather than malignancy.
  • Thirdly, you did not have symptoms such as persistent fever despite therapy, weight loss, tiredness, and any other symptoms suggestive of malignancy. So, your doctor might have said it could be a benign lesion.

For further queries consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist

Thank you doctor,

The pathologist's reports came back as 'concerning for cancer cells'. He said he does not have enough of a sample to have a definite diagnosis. He said each slide only had 10 cells on it. I just got a PET scan done.

Dr. Sunil Kumar Nookala

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine
#

Hi,

Welcome back to icliniq.com.

Sorry for your suffering.

  • Generally, the pathologist may require more tissue for diagnosis, so he or she would advise you to get a biopsy rather than a PET scan.
  • You have not uploaded your PET (positron emission tomography) scan, can you upload your pathology report and PET scan for further evaluation?

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

Thank you doctor,

Sorry, I do not have any reports with me.

Dr. Sunil Kumar Nookala

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine
#

Hi,

Welcome back to icliniq.com.

  • Sorry, but I cannot help you if I do not see the reports and the scans.

For further queries consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist

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