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Lung diseases

Granuloma in left lung

12/15/2009

Question:

I had a chest x-ray in August and got a call for a follow up x-ray. At the time I was away from my Dr. After returning home I called to reschedule. Was told to call Dr. I recieved a letter from him stating that I had a granulome left lung (scar) and that no further x-ray was needed. Do I need to be concerned about this?

Answer:

Granulomas are common scars that can be due to previous fungal infections or tuberculosis infection. In Ohio, up to 25% of otherwise normal people will have these from the fungus, histoplasmosis, that lives in the soil in our region. Granulomas generally do not cause problems themselves but they can be difficult to distinguish from other causes of pulmonary nodules ("spots") such as cancers. If the nodule is calcified, then it is a granuloma and no further evaluation is required. If the nodule has been seen on previous x-rays for at least 2 years and is unchanged, then it is a granuloma and no further evaluation is required. If it is a new nodule and is not calcified, then additional testing may be required to be completely sure that it is not a cancer. Testing could include a CT scan, lung biopsy, or follow up x-rays, depending on the size and location of the nodule as well as your risk of cancer (for example, if you have been a smoker in the past).

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Response by:

James N Allen, Jr, MD James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University