Hello. My mom had a chest xray yesterday that showed small nodular density in the right upper lung . The radiologist recommended another xray done with more oblique views, which she did today, to see if this may be an artifact, and again, it showed the same thing. Her doctor now recommends to have a CT scan. Will CT differentiate between benign and malignant process? Is it better to have it with contrast or without? Thank you! We worry what this density could represent. Oh, her last xray for comparison was in 2003 and was completely normal...
Hello dear, thanks for your question on Chat Doctor. Right upper lobe lesion can be due to any of the following. 1. Tuberculosis2. Pneumonia3. Lung cancer. So CT thorax should be done. It should be done with contrast.  Contrast is must diagnose cancer and infection. And yes, CT thorax is much more informative than chest x-ray in determining following details about lesion.1. Exact size of the lesion.2. Margins of the lesion. 3. Necrosis or calcification present or not.4. Involvement of surrounding areas5. Mediastinal lymph nodes involved or total these points are important in differentiating between benign and malignant lesion. So CT thorax with contrast is must.