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Will Slight Signs Of Early Emphysema Lead To Cancer?

Posted on Mon, 16 Dec 2013

Question: II need a follow up X-ray showed 2 small nodules one is 6mm the other smaller. Slight signs of early emphasyma or copd, revered for ct. No other symptoms just this cough . Will it definitely be cancer

Answered by Dr. Gyanshankar Mishra (4 hours later)

Brief Answer: HRCT scan thorax will clear the picture Detailed Answer: Hi, Thanks for the follow up. 1. Subcentrimetric nodules on chest Xray in a COPD patient could be due to old healed respiratory infections also. 2. HRCT scan thorax will be required to ascertain the number and size of such nodules. If any lnodule has a size near 1 cm, then a FNAC under CT guidance can be done from the same if required. Also the condition of mediastinal lymphnodes needs to be seen. 3. The various causes of nodules in the Xray could include old healed respiratory infections, spray paint exposure or malignancy (cancer is in the probable list since he is a smoker). Prior to the HRCT scan thorax it will be difficult to comment. 4. Do check for swelling of the finger tips if any or any nodes in the neck. 5. Get him evaluated from a Pulmonologist in detail and his spiromtery also needs to to be done for COPD management. Please do let me know the CT scan findings. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (6 hours later)

Thank you, if these nodules are cancer are they small enough to not be a death sentence just yet? with treatment?

Answered by Dr. Gyanshankar Mishra (21 minutes later)

Brief Answer: CT will be required to know their exact nature. Detailed Answer: Hi, Thanks for the follow up. First of all, please do not be worried. 1. Normally such small nodules in an otherwise normal lung being due to cancer is less likely. Hence its not proper to comment on the probable stage of cancer since the diagnosis needs to be substantiated first. In absence of any local spread eg. no mediastinal lymph nodes or mass, it will be a early stage cancer if at all, there is any chance of cancer. 2. It more likely seems to be a result of old healed infection i.e. old fibrotic nodules which are seen in copd patients due to some old respiratory infection or due to inhaled exposure to spray paint. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (18 minutes later)

Thank you so much this is really helping me cope, just waiting for the ct date. I was under impression that nodules versus persistent cough more than likely = cancer. it is a coincidence that he never coughed before the painting I will try to be positive and wait Thank you

Answered by Dr. Gyanshankar Mishra (38 minutes later)

Brief Answer: Please always stay positive in life. Detailed Answer: Hi, I would again like to emphasize here that please do not worry. It is very important to have a positive outlook in life. If possible please do update me with the scan reports. Good luck for the scan. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar