Indeterminate Pulmonary Nodules (Larger One 5mm)

Question

History of Testicular germ tumours, pure seminoma, History of smoking weed/Charas. Performed CT scan in 2020, small size pulmonary nodules are seen on right upper lobe, one with 5mm size at right lower lobe. A year ago in 2019 when cancer diagnosed first time, CT scan reported; No suspicious pulmonary nodules seen suggest pulmonary metastatic disease, Although 3mm soft tissue density on right upper lobe which remains indeterminate. Any suggestions if these nodules are Primary Tumours Mets?

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Prof. Dr. Ghulam Ali Mundrawala · Answer

do the PET  for metastasis and inform me

Dr. Nuzhat Perveen · Answer

The pulmonary nodule in above question is 3 mm and pt is smoker and also undergoing chemotherapy these nodules could be primary could be metastatic and they can be some pulmonary infection as chemotherapy increases the chances of rare pulmonary infections in my opinion a pulmonologist should review his ct scan physically and should underwent bronchoscopy and  biopsy and also send bronchoalveolar lavage for c/s afb smear and afb c/s and gene expert and fungal smear and fungal c/s to exactly know that whether its primary metastatic or some pulmonary infection but for all these things a pulmonologist review should be sought

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Prof. Dr. Ghulam Ali Mundrawala - Gastroenterologist

MBBS, MD (Medicine), MCPS | Karachi

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Dr. Nuzhat Perveen - Internal Medicine Specialist

MBBS, FCPS | Karachi

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