Is a bronchoscopy needed after a lung CT scan?

Hi doctor,

My CT scan says defined streaky opacity with associated loss of 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 a bronchoscopy after lung CT scan comes in, as the airway cannot be completely visualized on a CT scan.

Also, 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?

Kindly guide.

Thank you.

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-thirds 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 that some white blood cells were 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.

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 that if there was an obstruction in the airway, it would very likely be more of a benign growth than lung cancer.

1. Do you agree?
2. Why would it be more likely to be a benign growth than a cancerous lesion?

Thanks.

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.

Thank you doctor,

Sorry, I do not have any reports with me.