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Lung diseases

Noncalcified granulomata

12/01/2008

Question:

Hi, I am 45, I do not smoke. I recently had a chest x-ray which found scattered granulomas in the right and left lungs. I had a repeat x-ray 3 months later, saying again seen are three small round nodules in the right lung which could be due to noncalcified granulomata. It said nothing about the scattered granulomas on the left. As a child and teen, I had severe asthma,bronchitis,pneumonia, and pleurisy, I have pain sometimes in my lower right shoulderblade,after test was told it was GERD. Could the granulomas be related to the childhood illness or be cancer? I tested neg for TB. Could the granulomas in the left side go away by themselves or are they with you forever? I`m a worry wort. Please help Thank you

Answer:

Granulomas are common, especially in parts of the country where the yeast, histoplasmosis, is found. For example in the Midwest, granulomas can be found on CT scans in about 1/4 to 1/2 of older adults. The only way to know for sure that they are benign and not cancer is to either biopsy them or do further imaging. For patients who have a low risk of cancer, we generally do follow-up CT scans to insure that they are not enlarging. If they remain stable by either chest x-ray or CT over a 2 year period of time, we can be confident that they are benign. Granulomas are not related to asthma but can result from prior lung infections. They generally do not go away on their own. They usually do not cause any symptoms and pain in the right back would be an unlikely symptom of granulomas.

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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