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Respiratory Disorders  (Expert Forum)
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12mm non calcified pulmonary nodule
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National Jewish -
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MedHelp Member's Question

12mm non calcified pulmonary nodule

by jterry, Apr 07, 2006 12:00AM
I am a 27yo female. I had smoked for 14 years but quit just a couple of months ago and my maternal gradmother had bladder cancer, breast cancer and passed away from lung cancer. I had been having abdominal pain, chest pain and shortness of breath acompanied by intermittant fever and fatigue for a couple of weeks now and my doctor sent me for a chest xray and CT of abdomen and pelvis.  The CT showed a possible 12mm non calcified pulmonary nodule in the right lower lobe.  I am scheduled for a full CT of the chest with high resolution imaging in 3 days.  I work at a doctors office and just weeks ago our office diagnosed a lung cancer so I am very worried about this news. Is there a chance this is malignant given my history of smoking and family history of cancer?

I appreciate any and all replies!

Thanks,

JTerry
Doctor's Answer

by National Jewish, Apr 10, 2006 12:00AM
A 12 mm nodule is in the "small nodule" category.  The majority of these are benign and most are what are called granulomas.  Almost always granulomas are residuals of tuberculosis or fungal diseases, such as Histoplasmosis in the midwest and Coccidiomycosis in the southwest.  So this nodule could be due to an infectious problem, like tuberculosis, that could cause your symptoms.  Lung cancer in a 27-year-old woman, even one who has smoked heavily, would be extremely unusual.



There is a high probability that shortness of breath in a 27 year old is asthma, especially with an x-ray that is clear except for the nodule.  The negative abdominal and pelvic CT scan is re-assuring as it effectively rules out lymphoma and similar diseases.  Regardless of the outcome of the chest CT scan, your doctors will have to continue to investigate the cause(s) of your symptoms.  Your history of chest pain and shortness of breath is worrisome, as it raises the question of recurrent pulmonary emboli.
Member Comments (7)

by jterry, Apr 07, 2006 12:00AM
A little more of my history,  

The CT showed diverticulosis as the cause for my abdominal pain.  I have had ammenorrhea for 2+ years with no explanation(bloodwork and imaging show normal but do not ovulate anymore for whatever reason-have 2 sons ages 10 and 7 though) Last year I had an incidental finding of a 9mm cystic-lesion in the pineal region of my brain when I had any MRI looking for cause of vertigo and hearing loss.  Doctors believe I may have Menieres disease.  

JTerry

by Grand Rapids, Apr 08, 2006 12:00AM
I wouldn't jump to the conclusion that it's lung cancer, but I certainly wouldn't disregard the nodule either.  I have a 19 x 20 mm nodule and am still in the process of getting diagnosed.  In my research, I have found that the majority of lung nodules are not malignant, however, if you are a smoker, the chances are significantly higher.  A CT scan will provide a clearer picture, but my doctor told me that it's not a conclusive test to determine if it benign or malignant.  He also told me that docs generally don't perform additional tests on nodules until they are at 10 mm or more.  For smaller nodules, they typically monitor to see if it enlarges.



They attempted to do a fine needle biopsy on mine, but it came back with inconclusive results.  I guess it's kind of hard to hit a target that's less than an inch.



I don't think you should panic over this, but you should certainly follow through on the doctor's recommendation.



I can vouch for the fact though that there is that constant worry once you are told you have a lung nodule.  The best course of action, mentally, emotionally and physically is to continue to push to get a diagnosis and use the time in between to educate yourself on the topic.  The internet had more information on this subject than you can possibly ever read.



I hope you keep us informed on your progress.  God bless you and I hope everything comes out good for you.



Tom



by jterry, Apr 10, 2006 12:00AM
I have my second CT results back.  They confirm a somewhat oval shaped nodule measuring 13mm on the top of the right hemidiaphram.  It is indeed non calcified and therefore nonspecific.  I also have borderline bilateral hilar and mediastinal lymphadenopathy.  Not sure what significance the last part is.  Does any know?  I am scheduling a PET scan for as soon as possible.  Thanks for the response.

JTerry

by waiting2hear, Apr 14, 2006 12:00AM
Hi,

I am sitting here scared to death waiting for the doctor to call with results of my CT scan.

I quit smoking at the end of Dec when my father in law was diagnosed with cancer of the esophagus. I am 39, I will be 40 in July and I smoked for 25 years. Quitting for 3 years at one time.

I started having back pain on my right upper side in January and had started a strength training exercise program, in August of last year. So I wasn't too concerned. I went to the doctor for a physical in January and mentioned it to her. She said I had pulled some muscles. I went to the emergency room one weekend on Feb 19 and they decided to be on the safe side to take a chest xray and told me I had pulled muscles and that my xray looked fine. Nothing to worry about. They compared it to an xray I had, had in 2000. Everything looked fine.

Well I had a terrible coughing fit and had to go to the emergency room because I felt like a burning in my chest and I felt like my bronchial tubes might be infected. I ended up having "reactive airways" and I was told in the emergency room that my oxygen level was 100% and that my lungs sounded clear.

and that my xrays looked perfect!

So I was told to check in with my doctor before the weekend. I went to my doctor yesterday and thought I was just going to see how the inhaler they gave me was working for me. Well, my doctor let me read this report " The heart is not enlarged