General Question

Jude's avatar

What else besides cancer could be the reason for a "spot on a lung"?

Asked by Jude (32134points) June 2nd, 2009

My Dad went for a chest x-ray because of a cough that just wouldn’t go away, and the x-ray showed a spot on the lower part of his right lung. He had blood taken today and is scheduled for a cat scan next week…

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25 Answers

shilolo's avatar

There are a number of things that could involve the lung, although a better description (other than saying “a spot”) would help. These include:
1. Infections: Bacterial pneumonia, fungal pneumonia (coccidiomycosis, histoplasmosis, cryptococcus, blastomycosis), nocardia, Mycobacterium tuberculosis, lung abscess
2. Cancer: Lung cancer, metastatic disease, lymphoma, carcinoid, hamartoma, fibroma
3. Inflammatory: Rheumatoid arthritis, Wegener’s granulomatosis, sarcoid
4. Congenital: AV malformation, cyst
5. Other: Pulmonary infarct (clot), rounded atelectasis

For now, I wouldn’t worry too much. It could be a number of things, and often a solitary pulmonary nodule is benign. The CT scan will help with the diagnosis, and he eventually may need a CT guided biopsy. Good luck and best wishes.

Jude's avatar

@shilolo Thank-you. He’s been a smoker for almost 60 years, so, he’s quite concerned that it may have something to do with that. Here’s hoping that it’s not anything serious.

shilolo's avatar

@jmah With that history, I would be a bit more concerned about lung cancer. Combine the findings on chest x-ray with the fact that he is coughing blood, and the index of suspicion goes up for lung cancer. IF it is lung cancer, then depending on the extent of the disease, he might still be cured (if caught early enough, cure rates are very high; conversely, if caught late, cure rates are not very good). Again, best wishes to your family.

steve6's avatar

nice work

Jeruba's avatar

I defer to shilolo for medical advice. Let me just add, though, that my husband had a similar history and similar symptoms. It was lung cancer, stage 3a—not caught early at all. After he’d been through some months of chemo and radiation, an amazing doctor at UCSF pulled off an amazing surgery. My husband is now 3+ years post-surg and still clean. A cancer diagnosis is serious, all right, but there are also many great treatment successes these days. Twenty-five years ago it wasn’t like that, and my father didn’t make it.

shilolo's avatar

@Jeruba I am glad to hear about your husband. Having such late stage disease is typically a serious diagnosis, and it seems he has defied the odds. My quip above was based more on population statistics than individual cases. Obviously, each person wants the best outcome for themselves and-or their loved ones (and sometimes miracles do happen). However, in general the overall prognosis with late stage lung cancer is poor.

basp's avatar

best wishes to your dad.

chyna's avatar

My mom has had 2 spots on her lung, diagnosis lung cancer. The first one was 2 years ago and they gave her 20 treatments of radiation therapy. That spot was gone. This year, another one came on the other lung. In just 2 years the radiation has improved so much that only 5 treatments were needed. So far, that spot is gone too. My mom has emphazema and is on oxygen, so a biopsy or any type of surgery was not an option. She sailed through the radiation. It made her a bit tired was all.
Wishing your dad well.

RedPowerLady's avatar

**Hugs** for the waiting period because it can be so hard.
And positive thoughts your way that it is nothing serious.
But know that if it is there are still a lot of options.

augustlan's avatar

Sending good thoughts your way! Keep us posted, will you?

Darwin's avatar

My husband turned up with some spots on his lungs. One turned out to be an artifact of the way the x-ray recorded a blood vessel that was end on to the x-ray source. The others turned out to be little walled-off bits of tuberculosis – he was exposed when he was a child in the internment camps for Japanese-Americans but has never actually developed symptoms of the disease. However, he is a PPD converter so they weren’t all that surprised.

However, when first found, the spots were in bad places to biopsy, so we had to wait from just before Thanksgiving to just after New Year’s to see if they had grown or changed. That was one tough waiting period.

I hope your Dad’s CT scan shows that his lung spot is either nothing serious or easily treatable, and that the waiting period flies by for you all.

Jude's avatar

I just want to clarify – he wasn’t coughing up blood. He has a perpetual cough and was getting blood work done, yesterday.

@augustlan, I will.

steve6's avatar

Hope everything turns out well for you and your family. We will pray for you all.

Jude's avatar

@steve6 Thank-you.

He gets the C-scan done next week. Another thing that he complains about is excessive sweating (more so than usual) and usually by mid-day he feels that he has to take a shower because of the smell even though he showers first thing in the morning and uses deodorant. Not sure if this has anything to do with what we are discussing here.

shilolo's avatar

@jmah Has he has weight loss, fevers or night sweats? Where does he live, and has he traveled extensively? Does he have any history of exposure to tuberculosis?

Jeruba's avatar

Any news, @jmah? Worrying with you.

Jude's avatar

@Jeruba My Dad had the CT scan done. We asked him if he had gotten the results back and he said, no, the doctors office didn’t call him, but, he did see his doctor (who is a close friend) whilst out golfing and his doctor told my Dad that the results came back fine. Now, I want to believe my Dad, but, we (us) kids feel as though he could be hiding something from us. That’s his nature, really. His “pheumonia” has gotten worse. And, he’s had it for 2 1/2 months. He told me this morning that he’s going back to see the doctor. So, I don’t know what’s going on and what to believe.

shilolo's avatar

@jmah You are right to be concerned for your dad. Lot’s of people will be in denial, or decide not to burden their families with difficult news. Of course, it could be true that “everything is fine”, but better to know definitively. Unfortunately, doctor-patient privilege precludes the doctor from telling you directly without first obtaining your dad’s consent. You could ask your dad if he wouldn’t mind if you spoke to his doctor, and ask him to pass along his consent to the doctor. Then you can get more details… Best wishes.

Jude's avatar

@shilolo Thanks for your response.

A follow-up. A family member talked to my Dad recently, and my Dad told him that he needs to have his lungs drained (or, maybe, it was one lung. I’m not sure). My Dad has known this for awhile, but, has put off having the procedure done. He’s never mentioned any of this to his kids. My sister, who is an RN is a bit concerned and she’s going to talk to him about it today. Any idea as to why one would have to have their lung(s) drained?

Darwin's avatar

My husband suffers from congestive heart failure. Periodically he will get a build up of fluid in his right lung that simply will not go away no matter how much Lasix they use. At that point they often threaten to drain it.

I hope you can get your Dad to tell you what is going on.

Jude's avatar

@Darwin My sister thought, maybe, congestive heart failure. My Dad had a double bypass (which lasts around 10–15 years, and it’s been 10 years since he’s had it) takes heart meds and his Mom passed away in her 70’s from congestive heart failure. My Dad has been a smoker since age 17 and he is now 71 (still smokes).

I know, I hope that he tells us what is going on.

shilolo's avatar

What you describe is known as a pleural effusion. As the article describes, there a multiple possible causes, including heart failure, pneumonia, cancer and other rarer conditions. Typically, when it happens the first time, there is great interest in diagnostic testing to understand the cause but also to drain an amount (typically less than 1 Liter) to provide some relief (if the person is short of breath). With the “spot” and the effusion, I think he needs attention sooner rather than later. He might be in denial (seems that way), and might require vigorous encouragement to go, but I worry that the longer he delays, the worse things will get.

Darwin's avatar

My husband’s is due to failing kidneys.

Jude's avatar

Knowing my Dad, he’s afraid and is putting it off. My sister will have a good talk with him today.

When my Mom was dying of cancer, many times they had to drain fluid from both of her lungs. At times, she had 6 litres of fluid drained during a procedure (and this was only on one lung). Imagine 6 litres of fluid pressing on your lung. It was awful.

@Darwin I’m very sorry…

shilolo's avatar

@jmah 6 liters is a lot at once. Lots of doctors worry about issues arising from rapid reexpansion of the compressed lung, but after a while I imagine those concerns dissipate.

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