Doctor insights on:
Round Or Ovoid Pulmonary Nodule
It is a small: Lung mass. There are benign and potentially malignant causes. Whether it needs workup depends on its imaging features and your clinical history. Sometimes a biopsy is necessary to determine what it is, other times it can be safely followed or ignored. The presence of calcification is important because most of the time a calcified nodule is benign. ...Read more
Probably so: Biopsy of a lung nodule depends on the size and location. A nodule smaller than 1 cm is difficult to biopsy. A nodule located too close to the heart or main blood vessels is difficult to biopsy. A nodule too adjacent to the ribs may also be difficult to biopsy. In your case ct follow up at intervals by established guidelines may be considered. ...Read more
Lung mass: If a lung mass is seen on chest xray or ct scan and the patient has a moderate risk of malignancy, often the next test is a positron emission tomography (pet scan). This test detects masses with high metabolic rates. Around 95% of patients with a malignant nodule will have a positive pet scan. It is falsely positive in about 21% of patients, meaning that it will suggest cancer when it is not. ...Read more
Pulmonary nodule appears to be benign. Seeing pulmonologist. Should I bring up the emphysema at the same time?
Most definately.: I think your doc will likely pick up on it, but yes hey have to know all your medical issues. ...Read more
I have an irregular 5mm pulmonary nodule in right lung apex and a subpleural 4mm nodule there as well. What does this mean?
Pulmonary nodule: Need to see pulmonilogist. Get CT chest with IV contrast, especially if h/o smoking ...Read more
What is histoplasmosis? Does it affects lungs forming very small nodule, bcz of my lung nodule. Can it be seen in ct, ?
Yes: Yes, it can show as nodules in imagines. Consult your doctor for diagnosis and treatment should it become necessary. ...Read more
How is a 5mm non-calcified lower lobe pulmonary nodule in a non-smoker managed? Was found incidentally on a contrast CT of abdomen.
Fell on my back, had cat scan, revealed (2) 4mm lung nodule pulmonary doctor says I should have nothing to worry about, follow cat scan in 6 mnth?
Probably overkill: For nonsmokers, with nodules in that size range, we recommend no further follow-up. If you are smoker, stop smoking. If any follow-up is necessary, 12 months is probably all you need. ...Read more
Had a CT abd/pelvis w iv/contrast, findings;4.6mm pulmonary nodule in right lower lobe wout mineralization. Diff diag inc benign & malignant etiologies?
CT SURVEILLANCE: Accp guidelines recommend 2 years of low dose ct surveillance. Repeat ct 3 months x 2 then 6 months x 3 for a total of 2 years. Probably nothing. ...Read more
+ PPD test, CT scan solitary pulmonary nodule. 5mos after nodule stable/slight increase pet2.9suv bronchoscopy inflammatory no cough doc said remov?
More information is required. The pet uptake (measured in standard uptake value or suv), is low level, but not low enough to guarantee benignity. Given age and + ppd, I would suspect this could be an active granuloma.
Given your age, I would encourage consultation with a pulmonologist and full review of all your records first. Lung surgery is serious business. ...Read more
Positive PPD test, x-ray, CT scan shows solitary pulmonary nodule. 5 mos after nodule stable/slight increase. Doc said to remove. No cough not smoking?
Depends: Ppd positive, work-up details (quantiferon assay?), characteristics on chest x-ray, on ct-scan and/or treatment would be important. Depending complete work-up, risk factors, size, rate of growth/increase in size, etc. Location may be amenable to tran-sthoracic ct-biopsy or bronchoscopy transbronchial biopsy (flouro guided, inreach/em-nav guided, or ultrasound guided). ...Read more
Good day! Last aug I got allergies sneezing and colds but no fever and cough. Positive PPD test and X-ray and CT scan shows solitary pulmonary nodule.
Since you have a positive PPD skin test and lung imaging that has a solitary nodule, I would suggest that you have airway fluid cultures sent to a microbiology lab.
Your physician will order follow up imaging and prescribe treatment for you. Your household members should also be tested. ...Read more
I have a lung nodule in which the center is calcified in a bean shape within a round shadow, could it be malignant?
but should be followed with x-ray or ct.
Obtain any old films for tracking purposes. ...Read more
Would you operate at once if lung nodule went from 14, 2x10, 9mm-14, 2x 11, 6mm in a 2 month period, round, non smoker 55yo. Thoractomy 2 days later.
Follow for another few month since this may not be a change.
Full history, and review of all xrays and ct scans is appropriate.
If followed for some time already, and no other histoplasmosis or TB history, one might remove it.
The benign ones will stay about the same, and calcify over time.
Fear of delay diagnosing cancer is the issue since early removal has best survival. ...Read more
Why would a thoracic surgeon's assistant say he didn't understand why I was going to get my round lung nodule operated on? Should I go ahead with surgery?
First ask: Your question raises concerns of inadequate communication between thoracic surgeon and you. You should first discuss with your surgeon the mixed message and your confusion on goals of surgery. To properly consent, you need to have reasonable understanding of indication (why), risks, benefits, and medically reasonable alternatives. ...Read more
Surely, a thoracic surgeon must know if a round spot is a lung nodule, carcinoid or a coin lesion by looking at pet, CT and x-rays. Yes or no?
Pathology specimen: The pathologist makes the diagnosis with the microscopic exam of a piece of the lesion. Even then, it can be challenging to get diagnosis. So the answer to your question is no. Stay with your thoracic surgeon, get your follow up exams, stop nicotine if you have that addiction. Ok to go for a second opinion. Take a friend with you and don't be surprised if you get same answer. ...Read more
X-ray spot: It can be anything from an old inactive walled-off TB of fungus infection to a benign tumor to cancer to something as exotic as a dog heartworm that went far astray. Here in kansas, most are old histoplasmosis. But a spot is lung cancer until you & your physician have a reason to think otherwise. Good luck, and be brave. ...Read more
Solid mass in lung: A lung nodule is a soft tissue mass that is located somewhere within the lung itself. It can be a benign or malignant nodule. Following it with ct scans to see if it changes in size is one way to manage them or going directly to biopsy. ...Read more
Many options: Depends on age, size of nodule, history, and smoking history. Options include do nothing (rare), pet scan if there is risk for cancer, follow up cts at intervals determined by experienced md. Biopsies and surgery can come, but generally after above steps. Most nodules (>95%) are not cancer, and therefore invasive procedures should be reserved for when suspicion (guided by above factors) is high. ...Read more
Many pathways: Depends on age, size of nodule, history, and smoking history. Options include do nothing (rare), pet scan if there is risk for cancer, follow up cts at intervals determined by experienced md. Biopsies and surgery can come, but generally after above steps. Most nodules (>95%) are not cancer, and therefore invasive procedures should be reserved for when suspicion (guided by above factors) is high. ...Read more
Almost always, yes: Depends on your history and the appearance/location/shape of the nodule, but most often a follow up CT scan is the most appropriate test. Occasionally, if your doctor is concerned a PET scan may be useful for 8mm, but if its negative it is less helpful than when you have a larger nodule, for which PET is more reliable at excluding the likelihood of cancer. ...Read more