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This question was answered on Thu 12, Jun 2008 07:09am by Dr Paul S, MD

Went for calcium scoring ct scan and found 8mm nodule


    
Asked by pcmiller (Male; 47; Non-smoker, a few years of secondhand smoke exposure, Worked in a coal pit for a few years 30 years earlier; Relevant drugs:None ) on Wed 11, Jun 2008 10:13pm

My brother, who is 47 years old and a non-smoker, went for a calcium scoring ct scan and was found to have a 8mm left lobe lingula nodule. His cardiac results were moderate blockage and significant narrowing of a major artery. His cardiologist barely remarked on his heart, but the nurse called to refer him to a pulmonologist as soon as possible. Two years ago he had a chest xray that was normal and showed no nodule. It concerns me because if it grew to 8mm than it seems that if it is cancer, it is fast growing. So, my question is.....1) what are the chances that this is cancer? 2) Does the 2 year old xray have any significance on the nodule today? 3) Would a biopsy be done or would this be watched for a while. 4) Also, could a doctor tell from the ct scan whether this looks benign or malignant? Thanks for all your help.

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Answer by Dr Paul S, MD  on Thu 12, Jun 2008 07:09am:

Hi there. His previous X-rays are not reliable in detecting lesions that are this small, and it is possible that this lesion is nothing new. However, given the work history, it is best that this lesion be seen by a specialist such as a pulmonologist, and your concern that this can be cancer has its foundations. At this point, it is really very hard to say if this is indeed cancer, especially in the absence of other symptoms (weight loss, weakness, coughing, etc). The size of the lesion would also make diagnostic tests such as biopsy procedures to be very difficult, and we might be subjecting to patient to more harm than good. Also, the CT scan will not differentiate if this is malignant or benign. Even a PET Scan will have a hard time making conclusions in lesions this small. From the way I see it, your pulmonologist may recommend or advise a period of observation (2-3 months) after which, he may request for another scan to see if there are any changes. If the entire family is aggressive in pursuing the diagnosis, then percutaneous biopsy (CT scan guided) or an outright operation (to remove the nodule) may be discussed (but again, there are significant risks involved). I suggest that you discuss all of these options with your doctor when you get to meet (PET Scan, biopsy, observation, repeat CT scan, or surgery) and come up with a definitive plan. Whatever happens, I hope that everything will eventually turn out fine. Wishing you and your brother all the best. Regards and God bless.

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Follow up:

Clarification by pcmiller on Thu 12, Jun 2008 10:34am:
Thanks for all your help.  You've cleared some things up for me, and although I'm still in worry
mode, my whole family will give him lots of support and plenty of prayer.

Thanks again!

Comments:

Comment by Bea Smith on Sat 21, Jan 2012 06:58am: A few months ago I was diagnosed with calcified nodes on thyroid. One of these was 1.9cm, so biopsy was done with positive results. Now, after bouts of pneumonia, I have been diagnosed with calcified nodes of left lobe. I see pulmonologist next week. Do you see any proplem with these calcified nodes popping up and what can be done.

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