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Q. Is it my lung nodule that causes difficulty in taking deep breaths and yawning?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Aug 21, 2021

Hello doctor,

It is difficult for me to take deep breaths or yawn for the past three years. But, when I stand up, sit straight, or lean slightly forward, it often becomes easy to do so. I do cardio regularly for 45 minutes to one hour several times a week, but there is no improvement. My present medications are tablet Allegra and Vitamin D and B12.

My chest x-ray and CT chest show a 4 to 5 mm nodule located in the middle of the right lung. Is there a need for HRCT?

Kindly help.

#

Hi,

Welcome to icliniq.com.

Thank you for the query. I can understand your concern.

According to your statement, you have difficulty in taking a deep breath or yawn occasionally.

Yawning is a common reflex where your mouth becomes opened, takes in a deep breath, and exhales rapidly. After yawning, generally, you feel more relaxed.

When you yawn, your mouth becomes opened, and you have to take in a deep and long breath. Usually, yawning is the typical response of the body for drowsiness or fatigue. Yawning may happen when you become sleepy or tired.

Again, medications used in the treatment of depression, anxiety, or allergies may cause yawning occasionally. Yawning may occur as an automatic response from your body during positional changes.

Some psychological disorders such as anxiety, stress, depression, mood swings, irritability, malaise, lethargy, or lack of energy due to any reasons may cause yawning occasionally.

Again, underlying health conditions such as sleep disorders like sleep apnea or changes in sleep pattern due to shifting duty, thyroid hormone dysfunction, electrolytes imbalance, cardiovascular diseases, neurological disorders like stroke, seizures, or multiple sclerosis, respiratory diseases like bronchitis, emphysema, etc., also causes yawning occasionally.

Treatment depends on the underlying cause.

I suggest you taking the following investigations to find out the exact cause of your deep breath or yawn occasionally and then treat them accordingly.

1) CBC (complete blood count).

2) Thyroid function tests.

3) Serum electrolytes.

4) ECG (electrocardiogram).

5) ECHO (echocardiogram).

6) MRI (magnetic resonance imaging) of the brain.

Again, most of the pulmonary nodules are benign or non-cancerous. Less than 5% of pulmonary nodules may become cancerous in the long run.

A pulmonary nodule is non-cancerous if it is less than 9 mm. As your pulmonary nodule is 4 to 5 mm in size and without clinical features, initial follow-up at three to six months is needed. CT (computed tomography) guided FNAC (fine needle aspiration cytology) or biopsy from the pulmonary nodule may confirm the underlying etiology and diagnosis.

Take care.

Hello doctor,

Thank you for the reply.

Would an HRCT (high-resolution computed tomography) be beneficial?

Will it uncover things that are not revealed in a normal CT scan of the chest?

Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

I have already mentioned that HRCT (high-resolution computed tomography) of the chest is needed every three to six months for routine follow-up.

CT-guided FNAC or Biopsy from the pulmonary nodule will confirm its underlying etiology and diagnosis.

You can also take a chest MRI instead of HRCT of the chest for more detailed information.

Take care.

Thank you doctor,

These are my findings. In the chest wall or mediastinum, the heart is not enlarged. There are no coronary arterial calcifications. There is no pathologic mediastinal, hilar, or axillary lymphadenopathy or masses. There is an 8 mm fluid collection at the high right paratracheal region likely representing loculated pericardial fluid or a bronchogenic cyst. There is no pleural effusion or thickening. There is no diffuse septal thickening, honeycombing, bronchiectasis, ground-glass opacity, or nodule. There is no significant air trapping on expiratory images. There are no significant findings on the upper abdomen. The osseous structures reveal no acute abnormalities. These are the impression shown in the normal high-resolution chest CT.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. Your CT (computed tomography) scan report shows an 8 mm fluid collection at the high right paratracheal region likely representing loculated pericardial fluid or a bronchogenic cyst. If this bronchogenic cyst becomes large enough to press on the airways or esophagus or get infected then it can produce symptoms like chest pain, cough, breathing difficulties, trouble swallowing. If this bronchogenic cyst causes any symptoms that persist for a long time or bothers someone, then the treatment is surgical resection. Take care. Hope I have answered your question. Let me know if I can assist you further.

Thank you doctor,

This current size is unlikely to cause symptoms.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. Hopefully, a bronchogenic cyst or pulmonary nodule remaining less than 9 mm is considered as small and non-cancerous without any clinical features. As your cyst size is 8 mm, so I think that it will not develop any clinical features or complications that I have already mentioned. According to your statement told before 20 days, you have a pulmonary nodule of 4 to 5 mm size present in the mid-right lung. If your present CT scan report has indicated your previous 4 to 5 mm size of a pulmonary nodule as a bronchogenic cyst of 8 mm, then your previous one grows large.

You should consult your radiologist to know about your previous CT chest showing of 4 to 5 mm pulmonary nodule and present CT chest showing of bronchogenic cyst of 8 mm. Both growths are the same or previous pulmonary nodule has been vanished and a new bronchogenic cyst has appeared measuring 8 mm. As you do not have any clinical features at present, then do not be worried or upset. As I have already mentioned, CT-guided FNAC (fine-needle aspiration cytology) or biopsy from the lung growth will confirm its underlying etiology and diagnosis.

At first, consult your radiologist about the previous CT chest and present CT chest regarding the previous pulmonary nodule and present bronchogenic cyst, whether it is the same previous or new lung growth. Do not be worried as you are totally free from respiratory complications. Take care. Let me know if I can assist you further.


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