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What Does The CT Angiogram Report Indicate About My Chest Pain?
Question: Been having cough for ten days now. I was having chest pain especially when breathing so I went to emergency room. CT ANGIOGRAM CHEST was ordered. Thyroid nodules and lung nodule were found. What would you do if you received this report and I was your patient? Should I see any specialists?
INDICATIONS: Chest pain, recent endoscopy
Findings: There are multiple nodules of both lobes of the thyroid measuring 1.0 cm and larger. The axilla bilaterally is unremarkable. There is no mediastinal or hilar mass or adenopathy. The pericardium is intact. The thoracic aorta does not reveal evidence of aneurysm or dissection. There has been a cholecystectomy. The adrenal glands bilaterally are intact. The pulmonary arteries are well-opacified without evidence of filling defects. The central airways bilaterally are patent. The lungs are clear of infiltrates. There is no pleural effusion. There is no pneumothorax. There is an area of some thickening present in the left of the midline in the left upper lobe seen best on the axial images 39. It measures 1.9 x 0.9 cm. The bony structures of the thoracic spine are unremarkable.
Optional Information:
Person's Gender: Female
Person's Age: 49
INDICATIONS: Chest pain, recent endoscopy
Findings: There are multiple nodules of both lobes of the thyroid measuring 1.0 cm and larger. The axilla bilaterally is unremarkable. There is no mediastinal or hilar mass or adenopathy. The pericardium is intact. The thoracic aorta does not reveal evidence of aneurysm or dissection. There has been a cholecystectomy. The adrenal glands bilaterally are intact. The pulmonary arteries are well-opacified without evidence of filling defects. The central airways bilaterally are patent. The lungs are clear of infiltrates. There is no pleural effusion. There is no pneumothorax. There is an area of some thickening present in the left of the midline in the left upper lobe seen best on the axial images 39. It measures 1.9 x 0.9 cm. The bony structures of the thoracic spine are unremarkable.
Optional Information:
Person's Gender: Female
Person's Age: 49
Brief Answer:
Refer to the detailed answer below.
Detailed Answer:
Hello!
I had gone through your query and read very carefully your CT Angiogram report.
Considering the descriptions in this report there are 2 different issues to discuss:
1)The multiple nodules of both lobes of the thyroid gland.
Several conditions can cause nodules to develop in your thyroid gland such as Iodine deficiency,Chronic inflammation of the thyroid gland (Hashimoto's disease),
Multinodular goiter.
If I were your treating doctor with this description I would suggest a complete evaluation of your thyroid gland.This evaluation include tests to evaluate the function of the gland and imagine studies.
I would suggest to run these tests:
-Thyroid function tests : FT3, FT4, TSH.
-Thyroid ultrasound.
-Thyroid scan (if needed).
2) The second issue is the area of some thickening present in the left upper lobe
of your lungs.
Since you are having cough and chest pain when breathing the thickened area seen in CT might be related to a lung inflammation(probably bacterial infection).
In this case I would suggest to take a full course of antibiotic and then repeat the CT scan to see if there was a resolution of that area because in your case is important to know is this thickened area is due to inflammation or is a lung mass.
If after taking full antibiotic course the image of this area in your lungs has not change and is still there than other investigations are necessary to sort out the right cause.
I suggest to consult a pulmonary specialist for the lung problem and an Endocrinologist for your thyroid doctor.
Hope I was able to help you.
If you have further questions please feel free to write me,I will be happy to help.
Take care.
Dr.Rovena Murati
Refer to the detailed answer below.
Detailed Answer:
Hello!
I had gone through your query and read very carefully your CT Angiogram report.
Considering the descriptions in this report there are 2 different issues to discuss:
1)The multiple nodules of both lobes of the thyroid gland.
Several conditions can cause nodules to develop in your thyroid gland such as Iodine deficiency,Chronic inflammation of the thyroid gland (Hashimoto's disease),
Multinodular goiter.
If I were your treating doctor with this description I would suggest a complete evaluation of your thyroid gland.This evaluation include tests to evaluate the function of the gland and imagine studies.
I would suggest to run these tests:
-Thyroid function tests : FT3, FT4, TSH.
-Thyroid ultrasound.
-Thyroid scan (if needed).
2) The second issue is the area of some thickening present in the left upper lobe
of your lungs.
Since you are having cough and chest pain when breathing the thickened area seen in CT might be related to a lung inflammation(probably bacterial infection).
In this case I would suggest to take a full course of antibiotic and then repeat the CT scan to see if there was a resolution of that area because in your case is important to know is this thickened area is due to inflammation or is a lung mass.
If after taking full antibiotic course the image of this area in your lungs has not change and is still there than other investigations are necessary to sort out the right cause.
I suggest to consult a pulmonary specialist for the lung problem and an Endocrinologist for your thyroid doctor.
Hope I was able to help you.
If you have further questions please feel free to write me,I will be happy to help.
Take care.
Dr.Rovena Murati
Above answer was peer-reviewed by :
Dr. Raju A.T
How big is 1.9 x 0.9 cm lung nodule? What is the chance of a cancer? Should biopsy be done.Cough was ruled bronchitis would that cause lung nodule. Radiologist said follow up with post ct scan and further examination. Worried about small cancer as I was around two smokers for over 20 years indoors. Could thyroid be cancer or most likely not? Is nodules greater then 1 cm really big?
Brief Answer:
The cancer is not excluded.Need further evaluation
Detailed Answer:
Hello again Madam!
The thyroid nodules 1 cm or larger are not considered very small because in this size the nodules are felt in physical examination.But they are not considered big. This nodules most likely are related to chronic inflammation of thyroid gland or multinodular goiter.This conditions are associated with low thyroid function (Hypothyroidism).Thyroid cancer is less likely because it usually is presented as a single nodule but we can't exclude the possibility of cancer in mulinodular presentations.For this reason you need further evaluation.
A thyroid ultrasound is needed and depending on the result of other thyroid tests(ultrasound and functional tests ) the specialist will decide if it is necessary to run another investigation called Fine-needle aspiration cytology in order to evaluate the presence of cancerous cells in thyroid nodules.
Regarding your lung thickened area I have to clarify that from your CT angiogram report it isn't exactly a nodule or mass but it seems a soft tissue density that might be a inflammation of lungs (bronchitis,focal pneumonia,TBC) and follow up is needed to exclude a possible mass.
It is more prudent for you to consult a pulmonary specialist and according to physical examination and interpretation of image studies he can give you a specialized opinion for your problem and what to do further.Biopsy of lung nodule is the last examination for your case if the specialist has other evidences that it might be a possible mass (for ex if in the second scan after treatment the image is the same or larger,after have done bronchoscopy).
For these problems you are having is necessary further evaluation and consultation of specialists.
You don't need to worry in advance,just consult specialists for both issues (pulmonary specialist and endocrinologist) and let's hope for the best.
Hope it helps.
Wish you good luck with your investigations.
Let me know if you have further questions.
Dr.Rovena Murati
The cancer is not excluded.Need further evaluation
Detailed Answer:
Hello again Madam!
The thyroid nodules 1 cm or larger are not considered very small because in this size the nodules are felt in physical examination.But they are not considered big. This nodules most likely are related to chronic inflammation of thyroid gland or multinodular goiter.This conditions are associated with low thyroid function (Hypothyroidism).Thyroid cancer is less likely because it usually is presented as a single nodule but we can't exclude the possibility of cancer in mulinodular presentations.For this reason you need further evaluation.
A thyroid ultrasound is needed and depending on the result of other thyroid tests(ultrasound and functional tests ) the specialist will decide if it is necessary to run another investigation called Fine-needle aspiration cytology in order to evaluate the presence of cancerous cells in thyroid nodules.
Regarding your lung thickened area I have to clarify that from your CT angiogram report it isn't exactly a nodule or mass but it seems a soft tissue density that might be a inflammation of lungs (bronchitis,focal pneumonia,TBC) and follow up is needed to exclude a possible mass.
It is more prudent for you to consult a pulmonary specialist and according to physical examination and interpretation of image studies he can give you a specialized opinion for your problem and what to do further.Biopsy of lung nodule is the last examination for your case if the specialist has other evidences that it might be a possible mass (for ex if in the second scan after treatment the image is the same or larger,after have done bronchoscopy).
For these problems you are having is necessary further evaluation and consultation of specialists.
You don't need to worry in advance,just consult specialists for both issues (pulmonary specialist and endocrinologist) and let's hope for the best.
Hope it helps.
Wish you good luck with your investigations.
Let me know if you have further questions.
Dr.Rovena Murati
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you I will see the specialists. Forgot to mention my thyroid blood tests were checked recently all normal does that change anything
Brief Answer:
You still need further evaluation.
Detailed Answer:
Hello again!
Well the fact that your thyroid function is normal doesn't change anything because you still need to see a endocrinologist to evaluate your thyroid nodules.
The above diseases that I mentioned as possible causes are not excluded even with normal thyroid function because although I think you should repeat again these tests but the specialist will advise you what to do.
I am sure the specialist will give you all the answers after the evaluation.
Wish you good luck.
Best regards.
Dr.Rovena
You still need further evaluation.
Detailed Answer:
Hello again!
Well the fact that your thyroid function is normal doesn't change anything because you still need to see a endocrinologist to evaluate your thyroid nodules.
The above diseases that I mentioned as possible causes are not excluded even with normal thyroid function because although I think you should repeat again these tests but the specialist will advise you what to do.
I am sure the specialist will give you all the answers after the evaluation.
Wish you good luck.
Best regards.
Dr.Rovena
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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