I don't think the statement of the reporting radiologist, "No definite nodules are noted in the left lung" should be a cause for an alarm. It merely means there was no evidence of a lesion in the left lung.
As for the lesions in the right lung, they are intraparenchymal, which means they are in the lung tissue and not overlying it. The radiologist considers them to be of a non malignent nature, s/he has reported them of being post inflammatory granulomas.
Usually smaller nodules less than 5 mm in size are less likely to be cancerous, however, a close follow up is suggested.
Other probable causes of such nodules are previous tuberculosis, histoplasmosis (fungal infection), hematoma, vascular lesions etc. But cancerous nodules are in the list of differentials none the less and should be ruled out.
Non cancerous lesions usually do not require any treatment but a close eye is to be kept on them for any changes that might predict a serious nature. Your doctor will probably have you in for periodic imaging of these nodules for any change in size or shape or increase in number.
If the nodule appears as it was in earlier images and hasn't changed in size, shape or appearance, it's probably non-cancerous.
There can also be other likely causes of the shortness of breath, since you have a significant history of smoking, these causes can be ruled out on further work up, PFTs, is the right direction, conditions like COPD can be confirmed on spirometery (PFTs).
I think it would be better to see a Pulmonogist for his/her opinion on the non calcified nodules, as the whole point of a high resolution CT is early discovery.
Hope this helps, please click ACCEPT (Green Button) if it has, so that I may get credit for my time and effort. A bonus and a positive feedback will be appreciated.
Edited by Dr Uzair on 8/12/2010 at 9:05 PM EST