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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chest X-ray Revealing A Shadow In The Lung. Have Discomfort In The Armpit And Chest. Treatment?

Ive had a chest xray which revealed a nipple shadow,i went back for anothr chest xray and had nipple markers placed,it was then discovered the shadow is on my lung . I have discomfort under my left armpit and discomfort around middle of my chest. Im awaiting to go back to my gp next week to find out what the next plan of action is. Please could you give me any further advise. Thankyou.
Mon, 17 Sep 2012
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Pulmonologist 's  Response
Hi
Thanks for your query.
I think as per your history if the shadow is in the lungs and if it is single then we call it Solitary Pulmonary Nodule (SPN). There are many causes of SPN like infective like TB, Fungal inafection, neoplastic causes both benign like hamartoma and malignant like bronchogenic carcinoma or this shadow may be rheumatoid nodule or other CTD manifestations or may be a vascular shadow. Every possibility to be judged under your clinical context which you have not described here in much details. I will advise you to go for contrast enhanced CT scan (CECT) thorax for better deliniation of the shadow and CT guided fine needle aspiration cytology (FNAC) if possible to bring out the tissue diagnosis because it will be very helpful in the management purpose. Again CT guided FNAC if cannot be done then fibre-optic bronchoscopy (FOB) can be done to bring tissue for diagnosis. If on CECT it seems to be a vascular shadow then CT-angiography is to be done for diagnosis. That should be the approach from a pulmonologist's view point. Therefore you should consult a pulmonologist rather than a general physician for better opinion.
Thank you.
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  User's Response
Dr. Pavan Kumar Gupta's  Response
Hello
Since you have not mentioned your age and also did not mention about any other symptom besides discomfort around middle of chest,the best investigation for you would be to get a CT chest done to arrive at some conclusion.
Thanks
Pulmonologist Dr. Shashi Dangwal's  Response
Any shadow in the lung should not be ignored and should be thoroughly investigated. You need to undergo a Ct chest, sputum examination and if required a bronchoscopy. Consult a pulmonologist who will guide you properly.
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Chest X-ray Revealing A Shadow In The Lung. Have Discomfort In The Armpit And Chest. Treatment?

Hi Thanks for your query. I think as per your history if the shadow is in the lungs and if it is single then we call it Solitary Pulmonary Nodule (SPN). There are many causes of SPN like infective like TB, Fungal inafection, neoplastic causes both benign like hamartoma and malignant like bronchogenic carcinoma or this shadow may be rheumatoid nodule or other CTD manifestations or may be a vascular shadow. Every possibility to be judged under your clinical context which you have not described here in much details. I will advise you to go for contrast enhanced CT scan (CECT) thorax for better deliniation of the shadow and CT guided fine needle aspiration cytology (FNAC) if possible to bring out the tissue diagnosis because it will be very helpful in the management purpose. Again CT guided FNAC if cannot be done then fibre-optic bronchoscopy (FOB) can be done to bring tissue for diagnosis. If on CECT it seems to be a vascular shadow then CT-angiography is to be done for diagnosis. That should be the approach from a pulmonologist s view point. Therefore you should consult a pulmonologist rather than a general physician for better opinion. Thank you.