where can I find you, doctor? Have nodules for a few years, and getting smaller and getting bigger over a few years, doctors in my area couldn't find out what is the real cause, constantly have chest pain, and I cough sometimes, really need your help!
Thank you sir Could you please explain what definite structures in secondary pulmonary lobule cause tree in bud appearance like the way Kelley B line is formed by thickening of interlobular septa…?
Thank you. Given that the lymphatic system extends into the centrilobular portion of the secondary pulmonary lobule does that mean a perilymphatic process would also have centrilobular nodules? In which case how would differentiate from a random process? Many thanks.
Yes, but that will not be the predominant distribution. To differentiate from random, are the nodules clustered along the fissures and bronchovascular structures? If so, then it is perilymphatic. If they are not clustered on those structures, but some touch, some don't touch, then it is random.
I see that in the comments from some of your videos you mentioned some of the nodules may go away. My doctor said that pulmonary nodules (I have multiple, under 4mm) NEVER heal/go away. She was very adamant about this. We still haven't found the cause, however they noted 'inflammatory-infectious substrate/histiocytosis' in my papers after the CT scan and I am currently waiting for the bronchoscopy results. Would an infection typically be found through the bronchoscopy, as I was exposed to mold and I believe it is most likely infection? I'm really anxious about a biopsy, the bronchoscopy was bad enough!
Some do go away, but it depends on the cause. We can't always tell the cause of the nodule on a CT scan and that's why bronchoscopy is sometimes necessary.
I have bilateral pulmonary nodules some of which are calcified. On a noncontrast low dose ct. Radiologist impressions were likely benign granulomas all between 2 to 4 mm in the middle and lower lobes. Recommended follow up which is scheduled for November. I was a social smoker in my 20s to mid 30s. Quit for good 34 and am now 48. How do I know if this is likely metastatic disease
Dr Agrawal - Firstly, thank you for the excellent video. I have a question when you have a moment. I've seen "Peri-lymphatic" and "Peri-Bronchovascular" described as both separate and combined entities - for example, the classic appearance for Sarcoid. It appears from this video that they rarely, if ever, occur in isolation and that the 2 terms are better used interchangeably than as separate entities - would this be correct? Thank you again.
Yes they are often used interchangeably but sometimes in sarcoid the disease truly is more concentrated along the central bronchi and vessels. If that is the case I will use peribronchovascular. The term perilphatic includes peribronchovascular.
It depends on the cause. Sometimes there are treatments that can make them go away. In some cases they don't go away. There are many many causes of lung nodules so I can't really be more specific than that.
I think you have to just scroll up and down. The nodules will be isolated but the vessels will be connected. Oh and I should mention that you should not look for nodules if there are skip regions in your HRCT.
I had Sarcord and it jump from me arm to my lung now I have nodules had radiotherapy’s only one was growing they said it’s gone smaller and got more nodules on me lungs they said they scan every 3 months a now I have a shadow on me lungs I don’t now what going to happen there not telling me nothing also I have bowl cancer and they said can.not do anything for me I asked how long I have got left they said 5 years am 67 years old fragile and I have COPD this is the Reason. They want operate any advice please thank you 🙏
Hello Rishi, I have a question regarding the fleishner criteria. If you see a lung nodule that is 5.2 mm, would that be less than 6 mm? because in the recommendations it says - 6 mm is 5 mm and less. Please clarify. Also, can you make a video on differentiating solid and GG nodules? Thanks in advance
Hi Venkata, I don't think I understand your question. Can you link me to where the recommendations say 6 mm is 5 mm and less? Typically, if I have a solid 5.2 mm nodule, I don't follow it up unless there are risk factors. A 5.2 mm nodule would fall in the
@@ThoracicRadiology I found out it is Valley Fever and it caused a Paratracheal lymph node to grow to 12mm. I'll have to monitor this in coming months. I live in the desert. Outdoors a LOT. Caught it in the desert dust. Taking long to go away.
@@katstarbuck2626 Hope it clears up. That's caused by a fungus called Coccidiodes. Yup, you're right, super common in the desert where you live. Good luck to you.
@@katstarbuck2626 Glad you got an answer. Yup, you're right it comes from a fungus that is found out in the desert, and it can take a while to go away. Good luck to you. 🤞✌
Thank u sir i have question i have cough for last three months i consult with doc he performed chest degital xray and hrct chest and in chest ct "few small ground glass attenuating centrilobular nodules are seen in the apical segment of right upper lobe" is this normal are any serious please answer sir thankss
What does one do when nodules that kept changing. Watching. Then a hurried through bronscopy then opps get your affairs in order opps you have end stage small cell lung cancer. Opps. That's what happened to my late mother
As an R1 I'm sad it took me this long to find you. Thanks!!
Amazing thx for this video. I am a pulmonologist. This was of great help.
Compact video. Very useful! Keep up the amazing work
love it! you have such a relaxed and very clear teaching style, very useful! please do the TNM classification!
Excellent video, the best as far I have seen on the nodule, thank you very much
Brilliant video - thank you so much for taking the time out to do this!
Concise description, keep up the useful work.
Yes .. I wish there was more teaching like this .. others spend half the lecture citing research trials as though they were Bible verses
Very nicely put together, superb clarity on the algorithm as well 👌👍👏❤️ thanks much Dr. Rishi !
This is awesome. Thank you, Rishi!
Amazing..very helpful..thank you.
Thank you, very useful video.
Excellent video, Thanks for the efforts. Keep it up.
Very clearly explained! Thanks!
Fantastic video!
Amazing video, very very thankful.
very good , keep the good work . thank you .
Amazing video.
Very helpful. Thank you!
2:11 PERILYMPHATIC NODULES 5:50 CENTRILOBULAR NODULE 7:20 RANDOM NODULES
Thank you, sir. I ove your lecture and subscrubed!
thanx alot, could post a video of a solitary nodule please
Thank you sir
Thank you
Thanks!
It’s amazing.....all in a nut shell explain in such a wonderful way.......god bless u respected sir.....can we ask questions from u sir??????
Thanks for watching. Yes sure you can ask questions.
How about when you feel there’s something down your throat?
I had an MRI. It was clear
It should be a good Idea I've got thank you so muchhhhhh😊
thank you my freind you are amazing
a legend
where can I find you, doctor? Have nodules for a few years, and getting smaller and getting bigger over a few years, doctors in my area couldn't find out what is the real cause, constantly have chest pain, and I cough sometimes, really need your help!
Hi I have nodule upper right lobe over years it grew 1.5 cm scattered small nodules
👍
Thank you sir
Could you please explain what definite structures in secondary pulmonary lobule cause tree in bud appearance
like the way Kelley B line is formed by thickening of interlobular septa…?
Great question, it is usually caused by mucus plugging in the distal airways and acini.
Informative
Thank you. Given that the lymphatic system extends into the centrilobular portion of the secondary pulmonary lobule does that mean a perilymphatic process would also have centrilobular nodules? In which case how would differentiate from a random process?
Many thanks.
Yes, but that will not be the predominant distribution. To differentiate from random, are the nodules clustered along the fissures and bronchovascular structures? If so, then it is perilymphatic. If they are not clustered on those structures, but some touch, some don't touch, then it is random.
I see that in the comments from some of your videos you mentioned some of the nodules may go away. My doctor said that pulmonary nodules (I have multiple, under 4mm) NEVER heal/go away. She was very adamant about this.
We still haven't found the cause, however they noted 'inflammatory-infectious substrate/histiocytosis' in my papers after the CT scan and I am currently waiting for the bronchoscopy results. Would an infection typically be found through the bronchoscopy, as I was exposed to mold and I believe it is most likely infection? I'm really anxious about a biopsy, the bronchoscopy was bad enough!
Some do go away, but it depends on the cause. We can't always tell the cause of the nodule on a CT scan and that's why bronchoscopy is sometimes necessary.
I have bilateral pulmonary nodules some of which are calcified. On a noncontrast low dose ct. Radiologist impressions were likely benign granulomas all between 2 to 4 mm in the middle and lower lobes. Recommended follow up which is scheduled for November. I was a social smoker in my 20s to mid 30s. Quit for good 34 and am now 48. How do I know if this is likely metastatic disease
My grandmother had bronchitis never smoked
NICE
Dr Agrawal - Firstly, thank you for the excellent video. I have a question when you have a moment. I've seen "Peri-lymphatic" and "Peri-Bronchovascular" described as both separate and combined entities - for example, the classic appearance for Sarcoid. It appears from this video that they rarely, if ever, occur in isolation and that the 2 terms are better used interchangeably than as separate entities - would this be correct? Thank you again.
Yes they are often used interchangeably but sometimes in sarcoid the disease truly is more concentrated along the central bronchi and vessels. If that is the case I will use peribronchovascular. The term perilphatic includes peribronchovascular.
Good evening sir I had a question over the multiple Nodules do they have treatment for them to get read off completely
It depends on the cause. Sometimes there are treatments that can make them go away. In some cases they don't go away. There are many many causes of lung nodules so I can't really be more specific than that.
Excellent video sir..👍🙏
P.s. who are the 3 idiots that disliked the video?
I have a question, can a doctor see if someone have cancer with the blood test?
My doctor doesn’t give tests for cancer you have to ask
How to differentiate between nodules and vessels on hrct chest
I think you have to just scroll up and down. The nodules will be isolated but the vessels will be connected. Oh and I should mention that you should not look for nodules if there are skip regions in your HRCT.
Sir please make more videos
I had Sarcord and it jump from me arm to my lung now I have nodules had radiotherapy’s only one was growing they said it’s gone smaller and got more nodules on me lungs they said they scan every 3 months a now I have a shadow on me lungs I don’t now what going to happen there not telling me nothing also I have bowl cancer and they said can.not do anything for me I asked how long I have got left they said 5 years am 67 years old fragile and I have COPD this is the Reason. They want operate any advice please thank you 🙏
Hello Rishi, I have a question regarding the fleishner criteria. If you see a lung nodule that is 5.2 mm, would that be less than 6 mm? because in the recommendations it says - 6 mm is 5 mm and less. Please clarify. Also, can you make a video on differentiating solid and GG nodules? Thanks in advance
Hi Venkata, I don't think I understand your question. Can you link me to where the recommendations say 6 mm is 5 mm and less? Typically, if I have a solid 5.2 mm nodule, I don't follow it up unless there are risk factors. A 5.2 mm nodule would fall in the
@@ThoracicRadiology pubs.rsna.org/doi/10.1148/radiol.2017161659
Thus, the size threshold (
Ohok I see. Yes it depends on rounding. If you measure at 5.4 or less it is 5 and 5.5 and more, it falls into 6+ category.
Thoracic Radiology thank you very much for your reply. Can you please make a video on ground glass nodules, showing cases? Thank you in advance
I have a cluster on lingula all under 5mm. Also a 12mm Paratracheal nodule. Could this be Valley Fever? Or worse....cancer
Can't say for sure. Better to ask your doc about it
@@ThoracicRadiology I found out it is Valley Fever and it caused a Paratracheal lymph node to grow to 12mm. I'll have to monitor this in coming months. I live in the desert. Outdoors a LOT. Caught it in the desert dust. Taking long to go away.
@@katstarbuck2626 Hope it clears up. That's caused by a fungus called Coccidiodes. Yup, you're right, super common in the desert where you live. Good luck to you.
@@katstarbuck2626 Glad you got an answer. Yup, you're right it comes from a fungus that is found out in the desert, and it can take a while to go away. Good luck to you. 🤞✌
What is valley fever. Never heard of it
Thank u sir i have question i have cough for last three months i consult with doc he performed chest degital xray and hrct chest and in chest ct "few small ground glass attenuating centrilobular nodules are seen in the apical segment of right upper lobe" is this normal are any serious please answer sir thankss
I can't say what it is without knowing more about history. Best to ask your doc who knows more about you.
I have same cough and nodules on lung going for ct scan soon. How was your tests ?? Did you find out what it is ?
Hiii how r u feeling now and what ur said plz tell me
How r u feeling plz tell me I m also facing this
Are nodules the same as granulomas?
There are multiple causes of lung nodules. Granuloma is just one cause.
@@ThoracicRadiology thank you.
What does one do when nodules that kept changing. Watching. Then a hurried through bronscopy then opps get your affairs in order opps you have end stage small cell lung cancer. Opps. That's what happened to my late mother
I'm sorry to hear that.
I got 7 4mm nodules from COVID
I had 4 back in 2018 I have 6 now ranging up to 4mm. I wonder if catching covid added more? I have a pet scan coming up. Hope it's nothing.
COVID is not real. It’s a virus 🦠 or a bad cold. They said I had it I never felt any different
COVID isn’t real silly 🙃 it’s just a cold or bad flu they said I had it. I didn’t feel any different my boyfriend he just had the flu.
I have a question, can a doctor see if someone have cancer with the blood test?
I would think 🤔 they could my doctor never gives tests for cancer