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What Does No Infiltrate, Pleural Effusion Or Pneumothorax Mean ?

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Posted on Thu, 5 Jul 2012
Question: There is no infiltrate, pleural effusion, or pneumothorax.

There is a 3x5 mm pleural based nodule in the right lower lobe and a 4mm pleural based

nodule in the left lower lobe.
doctor
Answered by Dr. Gyanshankar Mishra (10 hours later)
Hi,

Thanks for posting the query on XXXXXXX

After going through your query, I would like to comment the following:

1. You do not seem to have any symptom at present.

2. Sub-centimetric nodules in the left lower lobe seem to have been detected on ct thorax.

3. I would like to inform you that, fewer than 1% of very small (<5-mm) nodules in patients without a history of cancer are malignant. Thus 99 % of such nodules are not malignant.

4. If no risk factors for malignancy are present (like smoking), then the nodule need to be observed for 12 months and a CT thorax plain and contrast be repeated at 12 months. If the nodule has remained unchanged then no further follow up.

5. PET (Positron emission tomography) is an optional alternative.

6. FNAC or biopsy from such small lesions is very difficult.

Thus in absence of any clinical features or risk factors, observation is the best strategy.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gyanshankar Mishra (3 hours later)
If something like this could become malignant is it good that it can be caught early to be resected or cut out?
doctor
Answered by Dr. Gyanshankar Mishra (17 hours later)
Hi XXXXXXX
Thanks for the follow up.

Ideally it is not recommended to go under the knife without confirmation of diagnosis. Also post resection there will be significant respiratory impairement. So the recommended approach is careful observation atleast for a year, and may be a PET scan.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gyanshankar Mishra (13 hours later)
Well I am 34, do you think they have been growing ever since I was little? I will forward reports to my internist
doctor
Answered by Dr. Gyanshankar Mishra (11 hours later)
Hi,

Thanks again for follow up.

It is difficult to say the duration of these nodules since you had no symptoms, however there is a possibility of some past healed infection resulting in these nodules.
The growth and origin of these can be commented only after an observation for a period of at least 1 year.
However from the clinical picture given so far , it seems to be a benign lesion.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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What Does No Infiltrate, Pleural Effusion Or Pneumothorax Mean ?

Hi,

Thanks for posting the query on XXXXXXX

After going through your query, I would like to comment the following:

1. You do not seem to have any symptom at present.

2. Sub-centimetric nodules in the left lower lobe seem to have been detected on ct thorax.

3. I would like to inform you that, fewer than 1% of very small (<5-mm) nodules in patients without a history of cancer are malignant. Thus 99 % of such nodules are not malignant.

4. If no risk factors for malignancy are present (like smoking), then the nodule need to be observed for 12 months and a CT thorax plain and contrast be repeated at 12 months. If the nodule has remained unchanged then no further follow up.

5. PET (Positron emission tomography) is an optional alternative.

6. FNAC or biopsy from such small lesions is very difficult.

Thus in absence of any clinical features or risk factors, observation is the best strategy.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB