Patchy Ground Glass

[Sad2022Guy]

6/28 - Per my cardiologists I had a Calcium Score done to measure my cardiac risk. I found out that my score was Zero (best you can get), but they found patchy ground glass - biggest 9mm - likely inflammatory.

Calcium Score - only focuses on 30-35% of the lungs because it’s a heart scan and not a lung scan…

Details - Male

Cancer - Yes - Skin Cancer 14.5 - 15 years ago - removed Mohs Surgery - was told that has nothing to do with any other type

Smoked - Yes (socially - stopped 10 years ago) I averaged 1.5 packs a week so not a lot

Here is my report (see below)

REPORT - SUMMARYExtracardiac: Patchy groundglass opacities posterior left lower lobeimage 27 through 29 of series 2 likely inflammatory. Consider follow-upas per Fleischner guidelines. No pleural effusion. No enlargedmediastinal lymph nodes.IMPRESSION:Coronary artery calcium score of 0, 25th percentile for age and gender.Patchy clustered groundglass opacities in the left lower lobe largest 9mm likely inflammatory. Follow-up as per Fleischner guidelines.

Background —— I got sick early June in the states helping a friend on their property. It was a combination of working outside one full day (Canadian wild fire smoke - was hard - very hard to breath) and also blowing leaves and dust that created a smoke cloud. I didn’t wear a mask during these two days and got sick for 2-3 days. Like 100% run down. It was lots of particles that bothered me so I was spitting up mucus for about 4-6 days (green and brown). That ended around 6/13 but still had a dry cough till 6/17 and my rest was on 6/28.

I had a meeting with my pulmonologist/ she said after looking at my scan there is no indication of cancer at this point / agreed likely inflammation - as the radiologist and said for me to a get a chest scan to rule out anything else. She also said honestly after u kept asking you are very Low risk and even if it was it would be removable.

I read GGO r cancer then I hear from my doc and uncologist who is a friend they aren’t. They r seen very very very often on scans. Sure they can but that’s rare. Not sure what to believe

She also said patchy GGO r very often a sign of scarring from an infection since there is many of them all over .. no clue what to believe

I am so scared of lung cancer

[Sad2022Guy]

FYI - the wildfire smoke was so bad I was tugging when I took in a deep breath for that one day. I think the cold was a combination of that and the dust cloud caused by the blows / zero 95 mask worn. I read mucus (green / brown) is a form of pneumonia who knows

[JanetteR57]

Your fear is understandable but from your post I would be reassured by your pulmonologist's report. It's unsurprising that your lungs have been damaged and you felt ill after breathing in such noxious fumes/particles as the lungs are quite delicate in those circumstances. hope you recover fully soon.

I had lung cancer (7cm tumour removed and half my left lung removed - diagnosed Jan 2011) and was back at work and swimming by end of March 2011. I'm a never smoker. Since end 2013 I've been involved in lung cancer research and lung screening in UK and Europe. Treatments for lung cancer have changed beyond recognition since then and even the surgery I had (open) is now mostly done via keyhole.

I'm not a medic but have been involved for nearly 10 years now and part of the UK clinical expert group and screening advisory group that works on quality standards for lung screening/lung cancer treatments.

The introduction of targeted lung health checks has revealed how common ground glass opacities and nodules are and the majority are not 'sinister'. There are strict guidelines to follow to monitor them - Fleischner being one of them - in the UK it's the British thoracic society guidelines if over a certain size. As your clinician states, many enlarge due to infection and inflammation and resolve over time.

The fires you were involved in could well have triggered both aspects to your lungs and oesophogus but should improve.

This video was created some years ago for the UK's lung charity highlights how common they are and how few turn out to be something sinister... even in a very targeted population (usually over a certain age and smoking history) like freckles/moles on the skin, most do not develop further. youtu.be/U3oirXkufno(Not working as expected?)

Technology and scans have enabled things to be found that otherwise would have been there but not harming the patient and even some breast and prostate cancers over more than 10 years study showed no overall difference if observed/watch and wait compared to aggressive cancer treatments if they proved to have any element of malignancy.

Yes, it's well known that earlier detection of lung cancer will lead to more treatment choice but there is always a balance of understanding that not everything found will actually turn out to be cancer.

Tests are done just as much to keep an eye on things and rule things out as much as rule them in.

Google is notoriously inaccurate and outdated when it comes to lung cancer information - if you want more accurate information, use trusted websites like roy Castle lung cancer foundation (used by clinicians and patients/public).

Good luck for any follow up

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hi Sad2022Guy

So sorry to hear of your lung problems and the appearance of patchy ground glass. This is understandably worrying for you. You have had an excellent response from JanetteR57 highlighting that although ground glass opacities can be both benign and cancerous, most are inflammatory and not sinister. I agree that you can be reassured by the Pulmonologist report and be reassured that the guidelines are there for follow up protection. I have little to add to Janette's answer, but if you do have anything you wish to discuss you can email ask the nurse at [e-mail] or call our free phone nurse led helpline number on 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600. Sometimes talking can reduce anxiety.

Wishing you all the best

Roy Castle Support Team

[Sad2022Guy in reply to RoyCastleHelpline]

Thank you! I was advised that the first thing they check for on the scan is for Cancer. Apparently from an oncologist I know told me that patchy ground glass (many) is usually formed from a past infection - inflammation that was caused in the lungs. Mucus was created etc like I had (brown - green) about 1.5 - 2 weeks prior.

They advised having another scan now, because there is no baseline. I had a Calcium Score test rather then a full CT. She also said lung cancer caught early is very very curable. Its just a lot to deal with.

FYI - Regarding the air pollution (one full day outside no mask).

Air quality can go from 0 to 500... Anything above 100 (unhealthy for sensitive group). It was 376 - 400 (Hazardous).