My Moms CT Results, help understanding???

Sorry in advance for the long post. First I have summarized the last 2 day’s events anmd start with mom’s CT Results (toward the middle of post) from yesterday. Afterward, I summerize her history after, there is substantial history. My question to those out there who may understand these findings, is does anyone think the above CT scan results indicate there may be progression of anything cancer related? Or any other condition that could be involved? In mom’s history I explain 2 prior CT scans revealed a 2 mm Cavitory Lesion that is being treated by a Pulmonologist as another bout of pneumonia, it looks to me the Lesion has grown to from 2mm to 3mm, along with other NEW findings such as the lymph node involvement that have never been found before. The Dr. messaged this morning to say the CT scan actually looked better????This makes absolutely no sense at ALL!!!! l am looking for feedback or any help understanding what this CT findings mean and what I should do to press for more aggressive or new treatment for my mom if need be? I feel like this has been going on way to long (2 1/2 years!!!) and the doctors are treating my mom as if she has stubborn pneumonia that will get better by treating the same way now as they have the last 2.5 years. I am very frustrated and scared. I just want my mom to want to live again, she is so tired and ready to give up. I would be grateful for any feedback or advice!!!!

TECHNIQUE: Multiple helical images were obtained at 5 mm slice thickness from the level of the thoracic inlet to the adrenal glands. Additional sagittal and coronal reconstructions were obtained.

Radiation dose reduction was utilized (automated exposure control, mA or kV adjustment based on patient size or iterative image reconstruction).

FINDINGS: The thyroid lobes are atrophic and grossly unremarkable. Anomalous right subclavian artery. There is mediastinal adenopathy with a 1.2 x 1.9 cm lymph node, an AP window 1.0 x 1.0 cm lymph node. There are coronary artery calcifications. The esophagus appears normal. The tracheobronchial tree appears patent. The heart is nonenlarged. No pericardial effusion. Lungs demonstrate biapical pleural thickening and patchy peripheral nodular opacities right upper lobe on image 27, left upper lobe and right upper lobe image 20, lingular nodule measuring 3 mm on image 40 with an adjacent 2 mm nodule, a spiculated right middle lobe mass measuring 1.0 x 0.8 cm within the right middle lobe. The breast tissue and both axillae appear normal.

BONES: Cervical spine plating. Thoracic spondylotic changes. Unremarkable sternum.

IMPRESSION:

1. PATCHY NODULAR INFILTRATES, SOME OF WHICH HAVE SPICULATED AND PERIPHERAL LOCATION WITH ADENOPATHY. FURTHER WORKUP AND A FOLLOW-UP EXAM TO FURTHER DOCUMENT CONTINUED RESOLUTION.

HISTORY: My mom who is 70 yrs old has been fighting chronic pneumonia for 2.5 years. She has had a history of smoking for 50 years. She came down with pneumonia and would be in the hospital sometimes a couple of times, get well for a month or two and then would get sick again. Her first CT scan 2.5 yrs ago showed small nodules in her lower lungs they just wanted to watch. Then early summer 2023 after getting ill again she was referred to a Pulmonologist, he diagnosed her with COPD and treated her for the pneumonia. Pneumonia again in September of 2023, pulmonologist ordered new CT, showed a Cavitory Lesion 2mm in upper right lobe, report said it had irregular boarders pointing out it could be possible malignancy or infection. Treated w/ antibiotics same as prior bouts of pneumonia. January 2024, guess what pneumonia, new CT Scan showed same Cavital Lesion but now 4mm. Her symptoms over the last six months have also become more severe. She now has to be on oxygen all the time. She has lost 50-60 lbs in the last 6 months. She is confused all the time and has severe short term memory loss. She looks awful. Her skin is gray with terrible black under eye circles. My once incredibly active mom has been sleeping all night and all but maybe 4 hours during the day. Taking a shower wears her out for 2 days. She had been on oral antibiotics for two weeks beginning early January, but after worsening symptomless had a follow up visit earlier than planned on 1/25. This visit I pressed for a biopsy, or treatment that would be more aggressive that would help her actually get better. Although the PA agreed it was time for a biopsy she said they had not done one yet because Lung Cancer did not normally present as a Cavitory Lesion but still felt something else needed to be done. She had to discuss with Dr. and called later that day and said the Dr. wanted to try 3 more weeks of antibiotics because the chest x-ray done the same visit still showed the lesion was there but said it “might” look a little better. I was upset but said ok. I read over the next two days everything I could read on Cavitory Lesions and chronic pneumonia and what I read said contradicted her statement that lung cancer doesn’t present as Cavitory Lesions. There are some that don’t but some cancers where CL is the primary way LC begins. So that’s the history in short. Current situation- mom is on day 6 of antibiotics. Dr. advised me to take her to ER yesterday after I called to tell him AGAIN that she seemed to be getting worse she’d O2 sat was worse and her lungs sounded worse and she literally was not able to get up and do anything. CT completed at ER. The ER Dr. indicated that there were new issues on her CT scan yesterday when comparing to previous CT scans. As I stated above, it looks to me the CL is bigger from 2mm to 3mm, she has plural fusion in both upper lobes, the CT also mentions opacities that haven’t been mentioned before. As well as the new lymph node findings. This along with her worsening symptoms don’t correlate with the Drs. message to me this morning that this CT scan actually looks better. Of course I have no experience when it comes to these issues, so any feedback would be appreciated!!!