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Different types of infectionsConditions that involve inflammation, such as sarcoidosis or granulomatosis with polyangiitisClumps of abnormal blood vessels, called arteriovenous malformations (or "AVMs " � for short)Conditions caused by breathing in harmful substances for many yearsConditions caused by using illegal drugs like heroinScars from an old infection that happened years ago, such as from a fungus, tuberculosis, or chicken pox
How will my doctor know what is causing my pulmonary nodules? " � To help figure this out, your doctor will ask about your symptoms and other medical conditions. He or she will want to know whether you worked around harmful substances you could have breathed into your lungs. If you have not had a CT scan done, he or she will order this test. � �
Your doctor will look at your X-ray and CT scan to see the sizes and shapes of the spots, and where they are in your lungs. He or she might be able to tell the cause of the nodules based on this information. � �
If you have old chest X-rays or CT scans, he or she will look at those to see whether the spots have changed over time. If the spots have not changed on CT scans from 2 years ago (or longer), they are unlikely to be cancer. They are most likely a type of scar on the lungs. � �
Will my doctor order more tests? " � If your doctor suspects that you have cancer, an infection, or inflammation, he or she will order more tests. These can include: � �
- Blood tests
- A skin test for tuberculosis
- Lab tests on samples of mucus that you cough up
- An imaging test called a PET scan " � If some of the nodules are 1/3 of an inch or bigger, your doctor might order a PET scan. For this test, a doctor puts a substance into your vein through a thin tube called an "IV. " � Then a special camera takes pictures of your lungs. This test can help tell whether pulmonary nodules are likely to be cancer.
- A procedure called bronchoscopy " � For this test, your doctor will put a thin tube with a camera and light on the end (called a "bronchoscope " �) in your mouth and down into your lungs. During this test, he or she can get samples of mucus from deep inside your lungs. Another doctor will look at the samples under a microscope and do lab tests on them.
If the results of these tests are unclear and there is a chance that the nodules are cancer or a disease that needs treatment (like an infection), your doctor will do a biopsy. A biopsy is a test that can tell for certain what's causing your pulmonary nodules. During a biopsy, your doctor will get a sample of tissue from one of your pulmonary nodules. Then another doctor will look at the sample under a microscope. � �
There are different ways a doctor can do a biopsy. To get a sample of tissue from a pulmonary nodule, your doctor can: � �
- Put a needle through your chest and into a nodule in your lungs
- Do bronchoscopy to get a sample of tissue
- Do surgery to remove a pulmonary nodule
What happens next? " � Based on your test results and individual situation, your doctor will decide if you need treatment for the nodules. � �
If your nodules are caused by a condition that needs treatment, your doctor will talk with you about what he or she recommends. � �
If your doctor thinks your nodules are a scar on your lungs, you probably won't need treatment. But you might need follow-up visits or CT scans to make sure your condition doesn't change or worsen over time. How often the scans are done depends on your individual situation. Most people have repeat CT scans over the course of about 2 years. � �
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 87303 Version 3.0 � �
Release: 22.8 - C22.208 � �
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