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Enervation post esophagectomy, CT scan shows pinhead spots on lungs. What other tests are recommended?

My husband has had an esophagectomy in April 2012 and recovered well until about 5 weeks ago when he lost energy and became exhausted. He has had a CT scan which shows pinhead spots on his lung . Because they are so small we are told he must wait for 3 months to have another scan and see if they have developed. Meanwhile he is on steroids which do not seem to have given him any more energy. Is th waiting wise as surely the cancer if itis cancer will just get bigger? Should he have any more tests at present? thank you so much for any advice. email is YYYY@YYYY
Asked On : Sun, 30 Dec 2012
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Pulmonologist 's  Response
HI dotsteenson

Thanks for coming to HCM

Pin head spots or miliary shadows have got several differential diagnosis.

The most important one is miliary tuberculosis...other can be viral infections, any hematogenous spreading infection, malignancy etc...

since you are on the steroid you must rule out the TB, at least by TST... because if it is TB there are chances of it to get flared up.

If TST is positive you may need Anti tubercular therapy.

best wishes
Answered: Mon, 1 Apr 2013
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