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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Smoker In Adult Life. X-ray Result Says Ill Defined Density. Lung Disease?

My mum s ( 65yrs. stopped smoking 1 month ago.smoked little but all her adult life) chest Xray result said : ill defined density mid rigt lobe lungs suspiscious for non benign etiology . She was referred to CT afte xray, we are waiting for CT results. Does ill defined density suggest nodule or mass or could it also be related to some other lungs disease? Also her blood result in last 2 months showed lowered neutrophils ( 1,23) Thank you Kristina Many thanks for answers. Now this is what we received after CT: the chest x-ray showed density in the right mid lobe anterior aspect, surrounded by inflammatory changes, overall features suggesting focal area of chronic inflammatory changes. Findings; no focal mass identified. no features of malignancy at this stage. all organs are normal. no enlarged mediastinal or hilar lymphnodes. no suspicious lesion identified. The focal are in the middle lobe anteriority has non - benign features, however if this density is still persistent in follow up x-ray, roceed with CT in 3-6 months. it all sounds good to me, except that'focal area has non benign features'. does it suggest it may becomes cancerous? and for that reason to monitor it?
Tue, 7 May 2013
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Pulmonologist 's  Response
Hi kristina,
Thanks for visiting HCM.
Ill defined opacity on chest xray can be anything ranging from simple consolidation ( bacterial, tubercular, fungal) to pulmonary infarction, cancer etc. Non- benign etiology in the report suggests cancerous growth. And it must be ruled out on CT scan thorax because it is fairly common in elderly smokers.
If it is suspicious on CT too, you may go for CT guided biopsy/FNAC of the nodule and get it examined by a histopathologist. The histopathological report will further guide the treatment.
The staging of the disease will be confirmed by the lymph node status on the CT scan and also the extent of the organ involvement other than the lung.

Meet your doctor with the Ct scan report .....

Best wishes
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General & Family Physician Dr. Luchuo Engelbert Bain's  Response
Hi and thanks for the query,
an ill defined density could imply lots of medical conditions, some of which are benign and others more serious. The low neutrophil level could indicate an issue with the bone marrow of a chronic infectious process.
Her past medical history, especially chronic smoking deserves a formal exclusion of a possible lung cancer. A CT scan and a fibroscopy could be of help to exclude such pathologies. \conditions like pulmonary Tb and common bacterial infections need to be sorted out too. A consultation with a pulmonologist could be of great help.
Thanks and best regards,
Luchuo , MD.
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

X-rays are shadows and could only suggest
With her age and smoking malignancy assumes top prority and has to be uled out
A definitive diagnosis needs biopsy and that is the only way
Consult a Pulmonologist / Oncologist...

Take care
Wishing speedy recovery
God bless
Good luck
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Smoker In Adult Life. X-ray Result Says Ill Defined Density. Lung Disease?

Hi kristina, Thanks for visiting HCM. Ill defined opacity on chest xray can be anything ranging from simple consolidation ( bacterial, tubercular, fungal) to pulmonary infarction, cancer etc. Non- benign etiology in the report suggests cancerous growth. And it must be ruled out on CT scan thorax because it is fairly common in elderly smokers. If it is suspicious on CT too, you may go for CT guided biopsy/FNAC of the nodule and get it examined by a histopathologist. The histopathological report will further guide the treatment. The staging of the disease will be confirmed by the lymph node status on the CT scan and also the extent of the organ involvement other than the lung. Meet your doctor with the Ct scan report ..... Best wishes