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Is it lung cancer if a fuzzy area is seen in the chest X-ray?

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General Surgeon
Practicing since : 1980
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They saw a fuzzy area in my husbands chest x XXXXXXX and think it's pneumonia his blood work came in normal. He was a smoker for 28 years and we are worried what if it's lung cancer? Does pneumonia ever get confused for lung cancer and would it shoe up in his blood work. He is 47 5'11 and weighs 193 lbs
Posted Thu, 3 May 2012 in Lung Cancer
Answered by Dr. Rajinder Bajoria 46 minutes later

Thanks for your query.

As your husband is a known smoker for the last 28 years. Smoking is known for its notorious role of causing variety of conditions in the lung including frequent pneumonia and possible lung cancer.

With the help of X-ray we can suspect pneumonia if other symptoms like cough, fever, breathlessness are present and to some extent confirm it. Lung cancer which is common in smoker can only be suspected, with similar X-Ray. A confirmation is needed with certain investigations. To confirm diagnosis or to rule out cancer in such patients we recommend CT scan or MRI. Sometimes bronchial wash via bronchoscopy for cytology.

As lung cancer also produces certain clinical sign & symptoms (no doubt not in early stages) like blood in sputum chronic cough, weight loss, recurrent bronchitis due to super added infection. I hope this is not witnessed in your husband's case. So pneumonia is more likely.

Next thing is to check with a Pulmonologist who have better experiences in such cases. Confusion of pneumonia over cancer can be expected while seeing Chest X-ray by normal physicians.

‘Hope I have answered your query, I will be available to answer your follow up queries.

Above answer was peer-reviewed by
Follow-up: Is it lung cancer if a fuzzy area is seen in the chest X-ray? 1 hour later
You did not mention anything about the blood work. Would there be something abnormal about the blood work if it may be lung cancer. How does cancer present it self on an x XXXXXXX as opposed to pneumonia?? Should we wait to see if it clears up with the antibiotics or should we ask for a CT scan now. What it the cure rate if it is the beginning stages of cancer??
Answered by Dr. Rajinder Bajoria 2 hours later

Nice to read from you again,
In case bacterial or viral pneumonia ,blood shows abnormality depending upon type of pneumonia( lobar,interstitial) in the form of raised total leukocyte count or white blood cells (WBC) ,along with increased poly-morph. ESR may or may not be raised in the early phase . X-ray shows consolidation in the lung parenchyma or tissue. But in case of malignancy blood count remains generally normal ,some times anemia may be there .If super-added by infection blood count is raised . ESR may be slightly raised in case of malignancy .Malignancy can present in a variety of form or lesions in X-rays depending upon the type of malignancy (small cell,large cell or adenocarcinoma etc. ) ,as small or large mass or cavitation or even with lymphadenopathy . Metastasis as coin shaped lesion on x-rays . But the X-Ray findings varies widely with the type of malignancy.Cancer presents with symptoms like cough that does not respond to antibiotics or treatment ,Constant chest pain ,blood in sputum while coughing ,breathlessness .loss of appetite and weight loss etc.

You can wait for a week or two for lungs to clear with a course of antibiotics. If no response even after a week or two go for CT scan. Cure rate for malignancy depends upon many factors like type & extent and spread of malignancy and also on the general health of patient..

There are many types of lung cancer. Each type of lung cancer grows and spreads in different ways and is treated differentlyIf you have pneumonia, you may have difficulty breathing and have a cough and a fever. A physical exam and history can help determine if you have pneumonia. Chest x-rays and blood tests can help determine what is wrong.

Hope I have answered your query, wish him Good Health and trouble free speedy recovery.
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