Undiagonised case. Also unremarkable.

What stands out in your case: The lung nodules have stayed small and stable over multiple scans, and importantly, they’re not “lighting up” on the PET scan — that’s actually a reassuring sign, since aggressive cancers usually do light up. Combined with completely normal blood counts, liver, kidney, and clotting tests, this makes leukemia or another blood cancer very unlikely, and it also makes it less likely the nodules themselves are the main cause of the pain.

• A tissue sample (biopsy) of one of the nodules — this is often the missing piece when scans and blood tests keep coming back inconclusive. A small surgical or needle biopsy can look at the actual tissue under a microscope, which can catch things scans simply can’t show, such as a lingering infection (including TB, which is always worth actively ruling out) or an inflammatory condition like sarcoidosis. • A rheumatologist referral, alongside the lung specialist — some inflammatory conditions (like vasculitis or sarcoidosis) cause exactly this pattern of small lung nodules with pain, fevers, and night sweats, sometimes with completely normal routine blood tests. A couple of specific blood markers (ANCA, IgG4) can screen for these. • An MRI of the spine or the nerve area near the shoulder/arm — since the pain is described as nerve-like (“pinched nerve,” “bursting”), and this is a different question from the lung nodules. CT and PET scans aren’t the best tool for catching nerve or spinal causes of pain, so a targeted MRI might reveal something the other scans missed.

please don’t take this as a diagnosis — it’s just meant to help frame questions for her actual treating doctors, who have examined her and know her full history in a way no online opinion can replace. Persistent fevers, night sweats, coughing blood, and pain this severe are symptoms that genuinely need close in-person medical follow-up, ideally without long gaps between appointments. If her pain becomes unbearable, her breathing worsens, or the blood in her cough increases, please don’t wait for a scheduled appointment — seek urgent medical care right away.