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Chronic Cough with multiple lung nodules.

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I have recently discovered via CT scan that I have 6 lung nodules ranging from .2cm-.8cm. The largest is calcified the others are not. I also have discoid atelectasis in the upper right lung where the large nodule is. For the last week I have had sorness in my right shoulder and behind my right scapula. It feels like someone is pushing their knuckles into the area that is sore. Additionally, I have a wheezing cough especially when laughing. My back is also sore right above my kidney area. Can you help tell me what to do next?

Category: Pulmonologist

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Category: Allergy and Immunologist
 27 Doctors Online


Thank you for asking your query at DoctorSpring.

I will require some additional information from you so that I can provide my best learned opinion.

1. May i know your sex, age, and smoking habits? an occupation history will also help.
2. Why did you do a CT thorax? or in other words, what where your primary complaints that prompted a chest x ray and then a ct of lungs?
3. About the calcified node - is it eccentric calcification / any adjective mentioned? are the lung nodules in one lung or in both lungs? any other positive findings mentioned - such as lymph nodes etc? what about your liver? (I know this might be too much of questions. Do not worry, just let me know if you have any information on these)

Next step will be further investigation -basic investigations - like a routine blood check up and stepping up after that with methods such as getting a sample tissue from that area with aid of ct or a scope passed into lungs. Pain if arising from that nodule is not a good sign and demands further investigation as early as possible. I will recommend a CT of abdomen also atleast upto adrenals and kidneys.
per se any calcified node need not cause any problem, and might represent a healed infection of chicken pox in childhood or histoplasmosis. However as the others are not calcified, and causing symptoms, we need to pursue them actively till found to be harmless.

I understand your concern might be cancer. But this finding is not particularly suggestive of cancer. So DO NOT worry. However it needs further evaluation to be 100% sure.

Hope this helps
Thank you
You can reply as a followup question. Awaiting your reply.


Patient replied :

Hi. Thanks for getting back to me so quickly. I work in a long term care facility with medically fragile children. I received the first x-ray because of a long term cough through occupational health at work and was referred for a CT when the x-ray showed the largest nodule. The nodules are in both lungs. I am 43 year old male, never smoked but was around secondhand smoke as a child. There is no mention as to what type of calcification is present and no mention of any findings in lymph nodes, abdomen or liver. My mother died from lung cancer at 60. Thanks again for your time and and help.


Your history can be summed up - as of chronic cough with multiple nodules in both lungs, remaining otherwise asymptomatic except for vague pain, no weight loss, no coughing out of blood, no exercise intolerance - as to a diagnosis, most probably is an occupational and environmental health issue or healed sequelae of an infective disease .

Cancer is less likely, so please do not worry. However as i had previously mentioned, sampling from the tissue is more important, and we need to proceed for Pulmonologists' opinion, CT guided biopsy or FNAC or a bronchoscopy.

Wishing you a fast recovery
Dr. Jacob George P.MD, FCCP

Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
Dr. Jacob George Pulinilkunnathil and 4 other Medical Specialists are ready to help you

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