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Thursday, August 21, 2014
My 82 yr old father has COPD and has been on 24/7 oxygen for a number of years. On CT also a number of years ago a right apical mass was found. It has been watched with a yearly CT scan. It had not grown until now. A bronchoscopy was done because he was hospitalized with increasing SOB and pneumonia. The mass was not biopsied due to its location. The physician did tell me that a mediastinal lymph node was enlarged. Due to my father`s age and severe lung disease no other diagnostic tests will be performed. Do these results indicate a malignancy? will it be staged, can it be staged? Any suggestions, additional medications that can alleviate some of the shortness of breath? Appreciate any assistance. Thank you
Thank you for your questions. There are several causes both benign and malignant that can present as a pulmonary nodule and lymph node enlargement. Given your father's age and comorbid lung disease, it is reasonable to first have a discussion with his provider regarding possible diagnoses and weighing risks and benefits prior to any attempt at diagnosis. In terms of his COPD, there are options to explore including optimizing his medical regimen as well as pulmonary rehabilitation.
Patrick Nana-Sinkam, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University