What is the chance i may have sclc with a left lower lobe pulm nodule 5mm with a clear tracheobronchial tree. positive anti-vgkc paraneoplastic test.

Very unlikely: I'm uncertain of the significance of the positive anti-VGKC test but I suspect it can be positive in the absence of a neoplasm. The likelihood of a nodule being malignant can be stratified by your age and the size of the nodule. LIKELIHOOD OF CA BY AGE: 35-39=3%, 40-49=15% ,50-59=43%, >60= 50%. LIKELIHOOD OF CA BY SIZE: <5mm =-<1%, 5-9mm =2-6%, 8-20mm =18%, >20mm =>50% chance of CA