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Pain in heart area, breathlessness, chest pressure, anemia. CT scan shows granuloma in upper lobe, calcified nodes. Meaning?

I have been experiencing pressure pain in my heart area, exhaustion, shortness of breath, constant pressure in chest which worsens with exertion, worsening anemia and just haven t felt well. Cardiologist nuclear test revealed heart is in great shape. I work out constantly and live a healthy lifestyle. My CT scan revealed 5.4mm calcified granuloma in right upper lob and 5mm granuloma in left upper lob, multiple calcified hilar and mediastinal lymph nodes. What does this mean?
Asked On : Tue, 26 Mar 2013
Answers:  2 Views:  151
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Cardiologist 's  Response
granuloma is a small area of inflammation in tissue. Granulomas are most often the result of an infection and most frequently occur in the lungs.over time, granulomas become calcified and have the same density as bone,
Infections that are characterized by granulomas include tuberculosis, leprosy, histoplasmosis, cryptococcosis, coccidioidomycosis, blastomycosis and cat scratch disease.
non-infectious granulomatous diseases are sarcoidosis, Crohn's disease, berylliosis, Wegener's granulomatosis, Churg-Strauss syndrome, pulmonary rheumatoid nodules.
although granulation are mostly asymptomatic , but they can cause anemia, shortness of breath and chest pain
so you should go for various tests ( ECG, ECHO, TMT) to rule out cardiac cause
and consult with a pulmonogist to find exact cause of granulatoion
Answered: Tue, 26 Mar 2013
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Pulmonologist Dr. Jabeed P's  Response
Your CT report says that there are granulomas in upper portions of both lungs. Granulomas are collection of infalmmatory cells produced your body attacks some foreign substance that persist in you body.
Hilum is the root of lung through which blood vessels and wind pipes enter and leave lung.
Mediastinum is the part of your chest in between the two lungs.
Both hilum and mediastinum normally contain lymphnodes.
These lymph are calcified due to some disease
The multiple calcified hilar and mediastinal lymph nodes raises the possibility of Sarcoidosis.
Sarcoidosis affects lymph nodes , heart skin ,lungs and ,many other organs.
It can also cause anaemia.
Other diseases that can give similar picture are tuberculosis and histoplasmosis.
You may need to undergo a Bronchoscopy ( visualisation of lung tubes ) to get the diagnosis.
During the procedure sample can be taken from mediastinal lymph nodes and examined.
In case the nodes are distant , Endobronchial ultrasound may be used for pinpointing them
Answered: Tue, 26 Mar 2013
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