Results of Follow Up Chest CT re pulmonary nodules - Next Step?
58 year old female, non-smoker (ex-smoker- quit on and off smoking for 15 years in 2008), no alcohol. Chronic illness, symptoms since January 2025 following query viral illness. Respiratory symptoms continue with SOB, wheezing, extreme fatigue, malaise, total weight loss of 44 lbs since onset of illness (current weight 106 lbs, 5’4.5”), asthma was ruled out by respirologist a couple of months ago (CT was taken June 25/26), overall malaise, weakness, unable to walk more than 10 minutes without use of walker due to chest pressure and fatigue. Was admitted to hospital in March 2026 for suspected pneumonia and treated with IV antibiotics for 3 days and discharged home. Symptoms have worsened over last 3 weeks. Comments from specialists are appreciated. CT Results below:
Clinical history: Follow-up of pulmonary nodule.
CT scans were volumetrically acquired through the chest using overlapping
3 mm collimation with low-dose technique. This is compared with a
previous CT pulmonary angiogram performed at on July 29, 2025, reported as negative for embolism.
The thyroid gland is unchanged showing a questionable nodule in the left
lobe.
The mediastinum and hilar structures are unchanged. There is no nodal
enlargement.
The pleural surfaces are unchanged, showing no effusion.
There is no coronary artery calcification. Mild aortic calcium.
Small basal nonspecific pericardial effusion unchanged.
Limited views of the upper abdomen are unremarkable.
The breasts show tiny calcifications on the right.
The central airways are clear.
Right lung shows worsening inflammatory nodularity in the upper lobeanteriorly around image 75, associated with some mucous plugging, mucous
plugging in the middle lobe image 68, 73, worsening nodularity image 73,
significantly worsening opacity in the middle lobe with micronodularity,
band atelectasis, mucous plugging, mildly smaller inflammatory nodularity
in the lower lobe around image 98, remainder not significantly different.
Left lung shows nodule apex laterally image 20 stable, calcified granuloma
anteriorly image 35 stable, new and worsening inflammatory nodularity in
the lingula, nodule anterior basal lower lobe image 96 stable, remainder
unchanged.
The thoracic skeleton shows no significant lesion. There may be small
hemangiomas in the mid thoracic spine.
Impression:
Overall there has been worsening of inflammatory opacities in both lungs
suggestive of atypical infection such as NTM.