where can I find you, doctor? Have nodules for a few years, and getting smaller and getting bigger over a few years, doctors in my area couldn't find out what is the real cause, constantly have chest pain, and I cough sometimes, really need your help!
Thank you. Given that the lymphatic system extends into the centrilobular portion of the secondary pulmonary lobule does that mean a perilymphatic process would also have centrilobular nodules? In which case how would differentiate from a random process? Many thanks.
Yes, but that will not be the predominant distribution. To differentiate from random, are the nodules clustered along the fissures and bronchovascular structures? If so, then it is perilymphatic. If they are not clustered on those structures, but some touch, some don't touch, then it is random.
Dr Agrawal - Firstly, thank you for the excellent video. I have a question when you have a moment. I've seen "Peri-lymphatic" and "Peri-Bronchovascular" described as both separate and combined entities - for example, the classic appearance for Sarcoid. It appears from this video that they rarely, if ever, occur in isolation and that the 2 terms are better used interchangeably than as separate entities - would this be correct? Thank you again.
Yes they are often used interchangeably but sometimes in sarcoid the disease truly is more concentrated along the central bronchi and vessels. If that is the case I will use peribronchovascular. The term perilphatic includes peribronchovascular.
Thank you sir Could you please explain what definite structures in secondary pulmonary lobule cause tree in bud appearance like the way Kelley B line is formed by thickening of interlobular septa…?
I see that in the comments from some of your videos you mentioned some of the nodules may go away. My doctor said that pulmonary nodules (I have multiple, under 4mm) NEVER heal/go away. She was very adamant about this. We still haven't found the cause, however they noted 'inflammatory-infectious substrate/histiocytosis' in my papers after the CT scan and I am currently waiting for the bronchoscopy results. Would an infection typically be found through the bronchoscopy, as I was exposed to mold and I believe it is most likely infection? I'm really anxious about a biopsy, the bronchoscopy was bad enough!
Some do go away, but it depends on the cause. We can't always tell the cause of the nodule on a CT scan and that's why bronchoscopy is sometimes necessary.
I have bilateral pulmonary nodules some of which are calcified. On a noncontrast low dose ct. Radiologist impressions were likely benign granulomas all between 2 to 4 mm in the middle and lower lobes. Recommended follow up which is scheduled for November. I was a social smoker in my 20s to mid 30s. Quit for good 34 and am now 48. How do I know if this is likely metastatic disease
It depends on the cause. Sometimes there are treatments that can make them go away. In some cases they don't go away. There are many many causes of lung nodules so I can't really be more specific than that.
I think you have to just scroll up and down. The nodules will be isolated but the vessels will be connected. Oh and I should mention that you should not look for nodules if there are skip regions in your HRCT.
Hello Rishi, I have a question regarding the fleishner criteria. If you see a lung nodule that is 5.2 mm, would that be less than 6 mm? because in the recommendations it says - 6 mm is 5 mm and less. Please clarify. Also, can you make a video on differentiating solid and GG nodules? Thanks in advance
Hi Venkata, I don't think I understand your question. Can you link me to where the recommendations say 6 mm is 5 mm and less? Typically, if I have a solid 5.2 mm nodule, I don't follow it up unless there are risk factors. A 5.2 mm nodule would fall in the
I had Sarcord and it jump from me arm to my lung now I have nodules had radiotherapy’s only one was growing they said it’s gone smaller and got more nodules on me lungs they said they scan every 3 months a now I have a shadow on me lungs I don’t now what going to happen there not telling me nothing also I have bowl cancer and they said can.not do anything for me I asked how long I have got left they said 5 years am 67 years old fragile and I have COPD this is the Reason. They want operate any advice please thank you 🙏
@@ThoracicRadiology I found out it is Valley Fever and it caused a Paratracheal lymph node to grow to 12mm. I'll have to monitor this in coming months. I live in the desert. Outdoors a LOT. Caught it in the desert dust. Taking long to go away.
@@katstarbuck2626 Hope it clears up. That's caused by a fungus called Coccidiodes. Yup, you're right, super common in the desert where you live. Good luck to you.
@@katstarbuck2626 Glad you got an answer. Yup, you're right it comes from a fungus that is found out in the desert, and it can take a while to go away. Good luck to you. 🤞✌
Thank u sir i have question i have cough for last three months i consult with doc he performed chest degital xray and hrct chest and in chest ct "few small ground glass attenuating centrilobular nodules are seen in the apical segment of right upper lobe" is this normal are any serious please answer sir thankss
What does one do when nodules that kept changing. Watching. Then a hurried through bronscopy then opps get your affairs in order opps you have end stage small cell lung cancer. Opps. That's what happened to my late mother
