My apical lung lesion ordeal

Who should I blame for the apical lesion scare? The radiologist or my immunologist who had amplified the findings?

A decade old letter from the rheumatologist says: she asked for xray baseline of my lungs because TNF-alpha and glucocorticoid may cause fibrosis. I went to visit my rheumatologist. Time travels so fast, unknowingly, 12 years has lapse since my last visit. This also means, that I am in remission. I asked her for her input on my xray films. She said x-ray film is clear. I said my immunologist said I have smoker's lungs and that lesion maybe a koch's lesion. I maybe put in immune suppresant. I need a pulmonary clearance from her. Was the scar caused by tnf-alpha or tuberculosis?

She said since I am in remission, it is not caused by TNF-alpha. It maybe caused by tuberculosis. Ok noted! I asked: Where is the lesion? Xray report says in the apical right lung. She replied, the radiologist is too good to see that small lesion. She feels it is clear. Ok noted again! Do I need to see a pulmonologist? She said the proper doctor to consult is an infectious disease doctor. So, he can rule out whether I had tuberculosis infection or not.

I then went to an infectious doctor. I told her I have an apical lung lesion, I suspect it is tuberculosis. What shall we do- what is tuberculin skin test? How do I know if the scar is new or old? Worst case scenario, if that were a Koch's lesion, what shall we do? I noticed she did not read my xray film. She just read the xray report. She suggested a tuberculin skin test. But, I will be going abroad I cannot come back after 48hours. I rescheduled the tubercullin skin test. I also told her I fear for a false positive. I told her I may have delayed cytotoxic hypersentivity reaction. She said it was meant to be that way.

Ring ring... Wow, I got a slot for consultation from by beloved immunologist. I tried my best to move him. I told him that I was bothered by his comment that I have smoker's lungs. And I am dying and yet he had not referred me to a pulmonologist. He laughed at my tuberculin skin test. What is the worst case scenario? He said he can put me on minimal immunosuppression + IvIg.

The pulmonologist said my xray is clear. I said the chest PA is clear but he needs to read the apico lordotic view. He laughed out loud and said it was clear. I showed him the xray report. He said my lungs are clear. No smoker's lungs also.

Bad immunologist! Same old comment: he is trying to kill a mosquito with a cannon ball. ^.^

I see this scenario as somebody sharing rumor about my trusted cashier in our store. When I secretly get feedback from her colleagues, I found out majority of the people can attest that the cashier is honest. But a selected few loyal staff will say otherwise. I am not zeroing out the possibility. I still trust to some extent. Deep in my heart, I believe the possibility that my immunologist theory is true. I close this issue for now.