Chest CT scan results/questions

Hi everyone!
My husband has been dealing with this cough for a few months now. He had an X-ray done and they basically said everything looked fine, which was a relief since his blood work and urinalysis from back in June were perfectly normal.
He tried some antibiotics, but the coughing just won't quit. Because he's been dealing with chronic sinusitis, he saw an ENT specialist a few times, and since things weren't getting better, the doctor suggested he get a CT scan just to be sure.
I was wondering if anyone could help me make sense of these results? I'm really looking for advice on what we should do next or if there are other tests he needs. I did a little searching on Google and saw that "nodular changes" might point toward cancer, which has me feeling pretty anxious, I guess. Also, I'm a bit confused about the part regarding his kidneys.
My husband is 71, and besides taking Pepcid for his GERD over the last few months, he isn't on any other medications.
Thanks so much in advance for any help you can give.

Here is the exact transcript from the report:
>>Native and contrast-enhanced transverse CT slices of the thorax were performed, along with supplemental MPR.
In the soft tissue window, there are enlarged lymph nodes in the left mediastinum, specifically pretracheal, measuring 13x7x17 mm.
Calcified lymph nodes are present in the right hilum.
There are diffuse scarring changes in the lung parenchyma bilaterally.
Subpleural fibrotic changes are more pronounced at the bases bilaterally, with destruction of the lung parenchyma in the posterobasal segment of the right lower lobe.
An irregular 1 cm nodular change is noted subpleurally in the posterior segment of the right upper lobe.
A 1 cm nodular change is located in the posterobasal segment of the left lower lobe.
No pleural effusion is detected.
Thoracic lordosis is present, with no evidence of osteolytic or osteoblastic lesions.
The liver, bile ducts, pancreas, spleen, and both adrenal glands appear normal on CT.
The right kidney is smaller in size with lobulated contours, showing no signs of stones or dilation of the collecting system.
In the convex area, at the junction of the upper and middle thirds of the left kidney, there is a lobulated hypodense zone, sharply demarcated, measuring 6.2x6x4 cm, containing central calcifications and visible parenchymal destruction; etiology is uncertain, differential diagnosis includes a complicated cyst or neoplastic process.
A cyst measuring up to 4 cm is present in the sinus of the left kidney and in the upper third.

Hey there,

I was wondering if it’s actually possible to get a lung CT scan without using any contrast dye—basically, can doctors still spot potential issues in the lungs if they don't inject the stuff?

About five months ago, I had a PET/CT scan that flagged some tiny nodules in my lungs, so now I need to go back in for a follow-up CT to see how things look. The big headache is that I had a massive, nasty reaction to the contrast last time, so I am dying to avoid getting injected with it again. I'm specifically talking about that IV contrast they pump in at the end of the scan.

Thanks a ton!

Nicholas Doyle91 said:Hey there,

I was wondering if it’s actually possible to get a lung CT scan without using any contrast dye—basically, can doctors still spot potential issues in the lungs if they don't inject the stuff?

About five months ago, I had a PET/CT scan that flagged some tiny nodules in my lungs, so now I need to go back in for a follow-up CT to see how things look. The big headache is that I had a massive, nasty reaction to the contrast last time, so I am dying to avoid getting injected with it again. I'm specifically talking about that IV contrast they pump in at the end of the scan.

Thanks a ton!

If those nodules are located strictly within the lung tissue itself, then yes—you can certainly proceed without any contrast.
Contrast is primarily utilized to provide better differentiation of structures in the mediastinum—think things like identifying lymph nodes or centrally located tumors, for instance.

After experiencing such a bad reaction to contrast, who could blame you for wanting to avoid it entirely?

Thanks a ton for getting back to me 👍 .

The nodules are right there in the lungs, though.
I'm really hoping nobody gives me any grief about the contrast, especially since the PET/CT report doesn't mention a single reaction to it.

Can someone help me make sense of these results? My pulmonologist ordered this because of chronic asthma and a cough that just won't quit.
Thanks!
Low-dose chest CT scan

Minor streaky, confluent scarring in the pleuropulmonary zones at both apices; a 2 mm subpleural nodule in the right lung parenchyma. In the lower right lobe, there's a soft interstitial nodule measuring 2.2 mm. There's also some slight lamellar subpleural consolidation in the middle right lobe—about 1 cm thick, 2.3 mm wide, and 3.2 cm long—which looks like old scarring or leftover inflammation.
Some minor streaky scarring is visible near the heart in the lower left lobe, above the diaphragm. No fluid buildup in the pleural space. As far as anyone can tell, there's no significant swelling in the lymph nodes within the hilum or mediastinum. No bone lesions seen in the skeletal structures. Adrenal glands look normal based on what's visible.
An expansive skin lesion is noted on the back, right of the spine, level with the lung apices.