Minimal atelectatic medically rt middle lobe and lingular area on lt with multiple small nodules with subpleural density and pleural-based no pleural effusion or pneumothorax what does this mean?

Several causes: Pleural or lung nodules can be the result of numerous causes, some of which can be serious. The fact that you are a serious smoker may be a factor here. You should direct this question to the doctor who ordered the study.

It sounds: Like you need to dicuss with the ordering physician. They will determine whether the nodules need a biopsy or close observation but consider nicotene gum.

Bronchoscopy: First you will need a diagnosis of what these nodules are. The atelectases in both lungs should be evaluated by looking at the airways to make sure there is no nodule in the airways causing collapse and in addition the bronchoscopy may just give all the diagnosis. Good luck.