Dear Dr. Gott: I am a 49-year-old man. Sometime ago, I had a chest X-ray. The report I received said that my heart and pulmonary vasculature appeared normal, but there was a slight prominence of the left-atrial segment. It also stated that tiny, calcified granulomas were noted bilaterally, but no acute chest abnormality was seen. I was told that I have old granulomatous disease. What does that mean? Is it serious or contagious? I fell 20 feet onto my back in my teens. Could this have done some damage to my chest and account for what was seen on the X-ray?

Reply: Granulomas are small patches of inflammation caused by infection, not falls. They primarily occur in the lungs but may be found in other parts of the body, as well. They are noncancerous. In your case, the granulomas are calcified, which signifies that at some point you had a lung infection. Most calcified granulomas are caused by a fungal lung infection known as histoplasmosis.

The good news is that most granulomas don't need treatment, and since yours are calcified, they shouldn't pose any risk to your health. However, because you have concerns, I urge you to speak to your pulmonologist.

Dear Dr. Gott: My husband is a cigar smoker. He quit smoking cigarettes 25 years ago but decided that an occasional cigar would be OK. That has now turned into several drags every hour or so. I am having trouble getting him to understand that this is not good for either us (me, because of the second-hand smoke) because his doctor has told him that even he has an occasional cigar and sees nothing wrong with it. My husband's smoking pattern is not occasional, but he still insists that because he only takes a few drags a day there is no danger.

Reply: There is an increased risk of mouth (lip, tongue, throat), oesophagus and lung cancers. This risk is even higher in those who smoke daily or inhale the smoke. The cancer risk is also increased for persons exposed to cigar smoke on a regular basis because of the way cigars are made and burn. I urge your husband to reduce or eliminate his cigar smoking.