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What do my lab test results indicate?

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Posted on Wed, 18 May 2016
Question: Normal, healthy 35 yo male. No surgeries, no major illnesses, no hospitalizations and 17 years on active duty military status (still serving). Physically fit at 6'5" and 215 pounds. Started getting sick (vomiting/nausea) almost weekly in November 2015. To date, lost 13 pounds. PCM shot Xray for gallstones, found nodule in left lung (no gallstones) and referred me for CT Scan. Called today and said everything looks normal on CT scan. Nodules likely from childhood illness; however, I had chest Xray in 2004 and 2014 and radiologist said "lungs clear". To me this means that they have grown to 7mm or were not there in 2004 and 2014 and have shown up in the past 15 months. Understand the calcified nodules are "old" but what about the other ones that are not? Additionally, they found a lesion within the right iliac bone near the mid aspect of the sacroiliac joint and want to do an MRI. I feel like we are being too dismissive of the results and that there may be more to this story. I might be wrong but nodules in lungs, lesion in iliac bone, sickness, etc don't add up to me. We have done no blood work, no other diagnosis other than "likely a previous infection." I want an additional set of eyes on the report and thoughts on the next steps.
doctor
Answered by Dr. Kaushal Bhavsar (4 hours later)
Brief Answer:
Get done MRI of pelvis.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
I have gone through the reports you have attached.
In my opinion, you should get done MRI of pelvis first.
This is to evaluate 1.5 cm bony lesion.
No need to worry for lung nodules because calcification suggest benign nature of nodules.
Malignant nodules rarely calcify.
But since you were not having any nodules till 2014 and now you developed few of them, better to get done repeat CT thorax after 9-12 months.
This is to see if any increase in size is there or not.
If it is increasing in size then possibility of malignant nodule is more.
If it is static or decreasing then no need to worry for these nodules.
Please let me know
1. Do you smoke?
2. Do you drink?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kaushal Bhavsar (32 minutes later)
Thanks for the detailed response! To answer your questions, I do not smoke or drink. I will look at scheduling a follow up CT scan later this year.

As for the bony lesion, should I be concerned? What causes them? What will the MRI tell me that the CT did not?

Thanks again for your time.
doctor
Answered by Dr. Kaushal Bhavsar (40 minutes later)
Brief Answer:
MRI will tell you more about the nature of the lesion.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, get done repeat CT thorax in the end of this year.
For this bony lesion, MRI is more informative. It will tell you more about nature of lesion whether sclerotic, lytic.
It will also tell you if any necrosis is there or not.
It will also tell about surrounding tissue involved of not.
So get done MRI of pelvis.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

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What do my lab test results indicate?

Brief Answer: Get done MRI of pelvis. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your concern. I have gone through the reports you have attached. In my opinion, you should get done MRI of pelvis first. This is to evaluate 1.5 cm bony lesion. No need to worry for lung nodules because calcification suggest benign nature of nodules. Malignant nodules rarely calcify. But since you were not having any nodules till 2014 and now you developed few of them, better to get done repeat CT thorax after 9-12 months. This is to see if any increase in size is there or not. If it is increasing in size then possibility of malignant nodule is more. If it is static or decreasing then no need to worry for these nodules. Please let me know 1. Do you smoke? 2. Do you drink? Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.