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What do we do now?
Mar 1, 2001

My husband is HIV+ with a non-detectable viral load and a CD4 of 150. Because of problems my husband had with breathing (wheezing), the Dr. ordered a lung x-ray. "Something" showed up so a CT scan was ordered. The results of the CT scan says of the "nodule": . . . "There is a lobular, 2 cm, soft tissue nodule located in the posterior segment of the right upper lobe. It has irregular margins. There is no internal calcium. The appearance is suggestive of a primary or metastatic malignancy, although a granulomatous process could also account for this. I have two questions: 1. I have never heard of "granulomatous" what is this? 2. What is the next step with this kind of test result? Thank you for your help.

Response from Dr. Dezube

Your husband needs to have this nodule biopsied as soon as possible. If it is cancer, then the sooner you find out the better. Biopsies can be performed either by a CT guided fine needle biopsy or by a bronchoscopy. Which technique will be done in your husband's case will depend upon several factors, such as the exact location of the lesion. A granulomatous process refers to the fact that certain diseases, such as tuberculosis, cause lesions, which are created by inflammatory cells. In other words, cells, which are seen in inflammation, group together and form a lesion, which may look like cancer on the CT scan, but is not cancerous.


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