Question: Dear Dr. XXXXXXX

Thanks for your expert advice and informative links re. my previous thread
http://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=198524

Back to my father’s lung issue. His severe cough and low grade fever started in mid April. I understand that in his 20 April chest x-ray, an opacity at right hilar region was noted. Two weeks later on 5 May, another chest x-ray was taken from another clinic due to persistent cough and on-and-off low grade fever. I just obtained yesterday the report on his chest x-ray done on 5 May 2015, which is uploaded here.

Anything of concern according to this report?

I note the report mentioned that “No sizeable hilar mass is seen. Slightly blunted bilateral costophrenic angles can be due to pleural thickening from previous insult.” Does this mean that there is/are hilar mass but only that they are not sizeable? Is it normal to have “not sizeable” hilar mass? Or presence of any “hilar mass” must be abnormal? If abnormal, what abnormalities can it be? Could it mean something cancerous?

My father has just done CT scan (without contrast due to renal impairment) and awaiting results. Feel so restless. Can you offer some advice taking into account the 5 May report?

Many thanks for your patience and attention.


Best Regards

Dear Dr XXXXXXX

Thanks for your response which has helped ease my mind.

I just get my father’s lung CT scan report, which is uploaded here. We will have appointment with our oncologist about 10 days later. Would like to have your early expert comments and see any issues that warrant attention and discussion with our doctor in next appointment. Grateful if you can offer your expert advice.

In particular-
1.     Regarding “centrilobular emphysemaand” and “a layer of collapsed lung” mentioned in the report, are they serious? What follow up actions are required? Is treatment needed?

2.     It is mentioned that there is “a mildly enlarged precarinal lymph node 1.5 x 1 cm” and “a mildly enlarged right paratracheal lymph node 1.3 x 1 cm.”. Is it worrisome? Has anything to do with cancer and risk of cancer?

3.     “probably reactive lymph nodes” is mentioned in the “comment” paragraph. What does “reactive lymph nodes” mean and what are the imp

4.     Anything or issues I need to raise to our doctor in our next appointment?

My father has smoked for over 30 years but has quitted for more than 10 years. Since his severe cough in mid April, he now still has mild cough, but only intermittently, with sputum at throat but not much.

Thanks. Look forward to your reply.

Best Regards,