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Have chest pain along with a tissue mass on upper lobe. On factive and azithromycin. Further?

Hi, I have a tissue mass on my right upper lobe, I have chest pain along along with the shoulder blade, short breath, cannot do much physical activity, the size of the mass increases if i spend too much time in cold places, drink a lot of cold drinks, smoke too much, and decreases when i am on antibiotics, i was given Factive and azithromycin for 7 days and the mass showed very small on the xray but it did not go away completely, I have done ct scan and still the doctors cant say what it is, a doctor told me to get Ct guided biopsy and another doctor asked me to do a bronchoscopy , I dont know which one to go for, so far i have seen 4 doctors and each of them asks me to take different tests, I am confused :( I am writing down the reports of the test i have taken so far X-ray Report: Homogenous well marginated elliptical opacity measures 4x8 cm seen at upper region of Rt. Chest partially obliterates the Rt. Hillar shadow, further evaluation recommended. Clear cardio-phrenic and costo-pherenic angles. Cardiac shadow of normal size and shape Ct Scan Report: Right upper lobe area of consolidation, cavitation, with adjacent fibrotic bands and bronchiectatic changes at its lower part. there is high density areas (varies from 23 up to 111HU) in the pre contrast study likely representing hemorrhage. possibility of tuberculosis should be considered and verified small subcentimeter mediastinal lymph nodes Normal CT appearence of the rest of right and left lung No pleural effusion No body lesion Esr result:09 tuberculin ppd result:0 3 times sputum for afb stain result: no afb seen sputum culture routine + gram stain report: mixed microbial growth from the upper respiratory tract flora, moderate growth of candida, alsicans Quantiferon Tb gold report: result 0.35 a negative test means no cellular immune reaction against M.tuberculosis has been detected. this is what i have gone through so far and now im confused about which test to take Ct guided biopsy or bronchoscopy and both of these tests are very expensive for me, Thanks my email id is YYYY@YYYY
Asked On : Thu, 16 Aug 2012
Answers:  1 Views:  62
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

The only sure way to diagnose any mass any where is biopsy
Everything else is indirect / can only be suggestive.
A biopsy is often possible with bronchoscope
CT guided biopsy will be the best solution in this situation

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Mon, 1 Jul 2013
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