Tuberculosis (TB): Practice Essentials, Background, Pathophysiology

Pulmonary Nodule (Spot On Lung): What Is It, Symptoms, And More - Healthline

Persistent cough and spots on your lungs after a chest X-ray or CT scan may be signs of noncancerous pulmonary nodules. In some cases, though, more tests might be required to ensure the nodules are noncancerous.

A spot on the lungs usually refers to a pulmonary nodule. This is a small, round growth on the lungs that shows up as a white spot on image scans. Typically, these nodules are smaller than three 3 centimeters (cm) in diameter.

If your doctor sees a pulmonary nodule on a chest X-ray or CT scan, don't panic. Pulmonary nodules are common, and most are benign or noncancerous.

Nodules are found on up to half of all lung CT scans. When a pulmonary nodule is cancerous, the spot or growth is usually larger than 3 cm or has other characteristics like an irregular shape.

Pulmonary nodules don't cause symptoms. You may have a nodule on your lungs for years and never know it.

If a spot on your lungs is cancerous, you may have symptoms related to the specific type of cancer. For example, growths caused by lung cancer may cause a persistent cough or breathing difficulties.

If your doctor believes a pulmonary nodule is cancerous, they may order more tests. Diagnostic testing used to confirm or rule out cancer includes:

Positron emission tomography (PET) scan: These imaging tests use radioactive glucose molecules to determine if the cells that make up the nodule are dividing rapidly.

Biopsy: Your doctor may order a biopsy, especially if the results of the PET scan are inconclusive. During this procedure, a tissue sample is removed from the nodule. It's then examined for cancer cells using a microscope.

Sometimes this is done by a needle biopsy that's inserted near the edge of your lung through the chest wall. Another option is a bronchoscopy where your doctor inserts a scope through the mouth or nose and passes it through your large airways to collect cells.

A pulmonary nodule may be first detected on a chest X-ray. After that, you may need further testing to better characterize the nodule to help determine if it's benign or cancerous.

Your doctor may request your medical history and your history of smoking. Additionally, your doctor needs to know if you've been exposed to secondhand smoke or environmental chemicals.

The first step of the process is examining the size and shape of the nodule. The bigger the nodule, and the more irregular the shape, the greater the risk of it being cancerous.

A CT scan can provide a clear image of the nodule and give more information about the shape, size, and location. If the results from a CT scan reveal that a nodule is small and smooth, your doctor may monitor the nodule over time to see if it changes in size or shape.

You'll have to repeat the CT scan a few times at regular intervals. If the nodule doesn't grow larger or change over a 2-year period, it's unlikely to be cancer.

In addition to a CT scan, your doctor may order a tuberculin skin test or more commonly an interferon gamma release assay (IGRA) to check for latent tuberculosis.

They may also request that your blood be drawn for additional tests to rule out other causes such as local fungal infections. These may include coccidioidomycosis (commonly known as valley fever) in the southwestern states like California and Arizona or histoplasmosis in the central and eastern states, especially in areas around the Ohio and Mississippi river valleys.

In most cases, your doctor can safely say that the nodule isn't cancer if it doesn't increase in size or develop points, lobes, or other irregularities over a period of 2 to 5 years. At that point, if you are not at high risk for lung cancer, there's no need for further testing.

If the nodule is cancerous, and there's only one, it's likely still in the early stages when treatment offers the best chance of a cure.

In some cases, a cancerous pulmonary nodule represents a metastasis from a cancer that began in another part of the body. If that's the case, treatment will depend on the original cancer.

Other causes of lung nodules are infections, inflammatory conditions, and benign tumors or cysts. If you have any of these underlying conditions, your doctor may recommend treatment that will depend on the underlying condition.

Lung Cancer Pictures: CT Scan, X Ray, And More - Healthline

If you have lung cancer, imaging tests like a chest X-ray will typically show a visible mass or nodule in your lungs. It will look like a white spot against the backdrop of a black lung.

An estimated 238,340 in the United States will be diagnosed with lung cancer by the end of 2023. Lung cancer is the second most common form of cancer in men and women in the United States.

Though a lung cancer diagnosis is serious, new and increasingly effective treatments are being researched every day. Early diagnosis and treatment may lead to a positive outlook.

Though lung cancer is common and can feel scary, the number of new lung cancer cases is decreasing, most likely due to positive lifestyle changes in the population and new treatments.

Here are some pictures to illustrate what lung cancer looks like.

Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, making up about 80-85% of all cases. There are three main subtypes of NSCLC: Adenocarcinoma, large-cell carcinoma, and squamous-cell carcinoma.

Adenocarcinoma: This is cancer that begins in the cells that secrete substances like mucus.

Large cell carcinoma: This type can appear in any part of the lung and spread faster than other types.

Squamous cell carcinoma: This cancer starts in cells that line the airways called squamous cells. The cancer cells tend to be found near major airways.

There are also two less common types of NSCLC:

adenosquamous carcinoma

sarcomatoid carcinoma

Small cell lung cancer (SCLC)

Only about 10-15% of all lung cancers are SCLC. This type can spread quickly and is often more challenging to diagnose early.

SCLC often responds well to chemotherapy and radiation, though it may often recur after treatment.

Lung cancer tumors

Other types of tumors can also occur in the lungs. Called carcinoids, these tumors grow slower than other types of lung cancer.

Carcinoids typically form in the lungs' airways — the bronchi (large airways) or bronchioles (narrow airways). A person may have different symptoms depending on where the tumor is growing, and the treatment may be different depending on where, exactly, the tumor is.

Carcinoids don't usually spread to other areas of the body. They aren't caused by smoking.

Several tests will allow your doctor to make a lung cancer diagnosis:

Chest X-ray

If you have any symptoms of lung cancer, your doctor may order a chest X-ray. A chest X-ray of someone with lung cancer may show a visible mass or nodule.

This mass will look like a white spot on your lungs, while the lung itself will appear black. However, an X-ray may not be able to detect small or early-stage cancers.

CT scan

A computed tomography (CT) scan is often ordered if there is something abnormal on the chest X-ray. A CT scan takes a cross-sectional and a more detailed image of the lung. It can give more information about abnormalities, nodules, or lesions — small, abnormal lung areas seen on X-ray.

A CT scan can detect smaller lesions not visible on a chest X-ray. Cancerous lesions can sometimes be distinguished from benign lesions on chest CT scans.

Your doctor cannot diagnose cancer with only an image from a CT scan or an X-ray. If they are concerned about the results of image tests, they will order a tissue biopsy.

Sputum cytology

If you can produce phlegm when you cough, microscopic cancer cells may be seen in this form of screening.

Biopsy

In a biopsy, your physician will take a tissue sample from your lungs for examination.

This sample may be removed via a tube placed down your throat (bronchoscopy), an incision at the base of the neck (mediastinoscopy), or by making an incision in the chest wall and using a needle to collect the sample.

A pathologist can then analyze this sample to determine if you have cancer. More testing may be needed to determine if the cancer has spread to other areas.

What is stage 1 lung cancer like?

This depends, first of all, on the type of lung cancer you have. In the case of NSCLC, stage 1 is when the cancer has not yet spread past the tumor itself to the lymph nodes or anywhere else.

What are the three warning signs of lung cancer?

Usually, you wouldn't develop symptoms of lung cancer until your disease is advanced. If you're experiencing a cough, shortness of breath, hoarseness, or any other signs that might be associated with lung cancer, and these symptoms do not improve with treatments for things like a viral illness or pneumonia, ask your doctor for a screening.

Can you see lung cancer on the skin?

Lung cancer is one of the most common types of cancer and may require quick and aggressive treatment. Some major milestones have been reached in clinical research to find more effective methods of treating it.

If you're worried about the risk of lung cancer, speak with your doctor about screening and prevention. They can help you determine what steps to take to treat or prevent lung cancer and any related conditions.

Ground Glass Opacity: Causes, Symptoms, And Treatments - Medical News Today

Ground glass opacity (GGO) refers to the hazy gray areas that can show up in CT scans of the lungs. These areas show increased density inside the lungs which could indicate pneumonia or other respiratory disorders.

The term comes from a technique in glassmaking during which the surface of the glass is blasted by sand. This technique gives the glass a hazy white or frosted appearance.

This article will look at what GGO is, some of its causes, and its treatment options.

GGO refers to gray areas that can show up in lung CT scans.

Normally, the lungs appear black in X-ray and CT scans. This indicates that they are free of any visible blockages.

However, gray areas indicate increased density, meaning that something is partially filling the air spaces inside the lungs. This could be due to:

the air spaces becoming partially filled with fluid, pus, or cells

the walls of the alveoli, which are the tiny air sacs in the lungs, thickening

the space between the lungs thickening

GGO can be due to many conditions. Sometimes, the cause is benign. Other times, it may be the temporary result of a short-term illness. However, it can also indicate a more serious or long-term condition.

There are several types of GGO. These include:

Diffuse: Diffuse opacities show up in multiple lobes of one or both lungs. This pattern occurs when the air in the lungs is replaced with fluid, inflammation, or damaged tissue.

Nodular: This type can indicate both benign and malignant conditions. GGO that persists over several scans may indicate either premalignant or malignant growths.

Centrilobular: This type appears within one or several lobules of the lung. Lobules are the hexagonal divisions of the lung. The connective tissue between the lobules is unaffected.

Mosaic: This pattern develops when small arteries or airways within the lung are blocked. The opaque areas vary in intensity.

Crazy paving: Crazy paving shows up as a linear pattern. It can occur when the spaces between the lobules widen.

Halo sign: This type of opacity fills the area around the nodules.

Reversed halo sign: A reversed halo sign is an area that is almost totally surrounded by liquid-filled tissue.

The shape, size, quantity, and location of opacities will vary depending on the cause. Some conditions cause only one type, but others may cause a mixture.

The sections below will look at some potential causes in more detail.

Infections are common causes of GGO. Such infections include:

Pneumonia

Pneumonia is a serious infection in the lungs. It can result from viruses, bacteria, or fungi.

The symptoms can vary depending on the cause, but they typically include:

A doctor may prescribe antiviral medications to treat viral pneumonia. Doctors also treat bacterial and fungal pneumonia with medications. However, sometimes symptom management and rest is enough.

COVID-19

A 2020 systematic review and meta-analysis found that just over 83% of people with COVID-19-related pneumonia had GGO.

Another 2020 study in 54 participants found that GGO most commonly showed up in the lower lobes of the lungs as round opacities, but that as the disease progressed, it became more patchy and affected all lobes.

Pneumonitis, or inflammation in the lungs, can occur if a person inhales:

allergens or irritants, which can contribute to hypersensitivity pneumonitis

electronic cigarette smoke, which can cause e-cigarette or vaping product use-associated lung injury (EVALI)

toxins, such as asbestos

Certain drugs can also cause pneumonitis and accompanying GGO. Typically, this type of pneumonitis occurs shortly after a person begins taking a new drug.

Hypersensitivity pneumonitis

The symptoms of hypersensitivity pneumonitis can include:

a cough

short-term shortness of breath

fever

pain

In the short term, doctors treat this condition by trying to identify and remove the trigger of a person's symptoms. The person may also require medications and oxygen therapy.

In the long term, the condition may cause chronic fatigue, weight loss, and irreversible scarring.

EVALI

E-cigarettes and vaping devices contain nicotine concentrates, solvents, and other chemicals. These products can cause EVALI.

EVALI may cause numerous types of GGO, including crazy paving and reversed halo sign, to show up on a scan.

Vaping can also cause alveolar hemorrhage. There is more detail on this condition below.

These conditions could be due to an autoimmune disease, a connective tissue disorder, or toxin exposure.

The progression of interstitial lung disease varies from person to person depending on what caused it.

Symptoms vary from mild to severe. They may include:

shortness of breath

labored breathing

a dry cough

severe tiredness or weakness

mild chest pain

unexplained weight loss

Treatment aims to slow the progression of the condition. Doctors may use supplemental oxygen, anti-inflammatory drugs, or immunosuppressant drugs.

coughing up blood

shortness of breath

difficulty breathing when lying down

sweating

restlessness

blue- or white-tinged fingertips or lips

People with these symptoms should seek medical attention immediately, as sudden pulmonary edema can be an emergency.

Alveolar hemorrhage occurs when the blood vessels in the lungs become damaged, leading to bleeding.

The symptoms can vary widely and may include:

coughing up blood

difficulty breathing

anemia

respiratory failure

Doctors treat most cases of alveolar hemorrhage with steroids to reduce inflammation and immunosuppressants to stop the immune system from damaging the blood vessels further.

Sometimes, GGO nodules in the lung can indicate cancer.

Lung cancer may not have pronounced symptoms in the early stages of the condition. However, a person should speak with their doctor if they experience:

a persistent cough that worsens

shortness of breath

pain in the chest, shoulders, or back

voice changes

weight loss

Treatment varies according to the severity and type of cancer a person has. It may include chemotherapy, surgery, and radiation therapy.

After a doctor finds GGO in a CT scan, they will take note of the size, shape, location, and distribution of the opacities to determine the likely cause.

They may also order more tests, such as:

lung function tests

sputum tests

blood tests

bronchoscopy

lung biopsy

a CT scan, for those who have received X-rays, as CT scans show more detail

Receiving test results can be worrying. Here are some questions that a person may wish to ask their doctor:

What can the scan results tell us?

In which part of the lung is the GGO?

What type of GGO is present? Are there multiple types?

Could it indicate a benign condition?

Will other diagnostic tests help determine the cause?

The following are commonly asked questions about GGO.

How serious is GGO?

GGO develops due to many conditions, meaning that there are varying degrees of severity. Some causes are benign, and other causes can be more serious, such as lung cancer.

Is GGO a tumor?

GGO nodules are an important indicator of lung cancer. However, it is important to remember that there are many causes of GGO, which can be present in benign conditions.

GGO can show up on a CT scan of the lungs. It appears as hazy gray areas that can indicate a range of conditions.

Some causes of GGO may be benign and resolve on their own, while others may be chronic.

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