1. < Lung Health

Is a Spiculated lung nodule always malignant?

Posted by darwin66 @darwin66, May 16, 2023

Hello,
58M, Nonsmoker, No history of cancer
I went to a pulmonologist due to coughing, shortness of breath for over 2 years and got diagnosed with allergic asthma.
Ct scan showed 5 lung nodules all on the right lung.
2 are calcified -most likely granuloma,
2 perifissual- which are most likely benign
1 subpleural nodule 5mm
1 spiculated nodule 5mm
The spiculated lung nodule worries me the most
I did research and all data and studies say that spiculated nodules are malignant with a predictive value of up to 90% ..
Doctor wants to just monitor it with follow up Ct scans.
I read that in rare cases infections, Inflammation or sarcoidosis can have Spiculation but Generally such nodules are a sure sign of Malignancy.
Anoyone on here who has experience ?

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Ingegerd Enscoe, Alumni Mentor | @astaingegerdm | Oct 15, 2023

@valerie131
You are tough too.
Suffered through chemo but breast cancer did not return.
It’s very helpful to have pulmonologist guide you.
I happened to have one before because of asthma and he’s very good.
Let me know what happens!

REPLY
h2opup54 | @h2opup54 | Oct 16, 2023
In reply to @valerie131 "I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In..." + (show)
@valerie131

I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In January I had a CT and it was 7mm so my doctor ordered a follow up ct for in July. I didn’t have it done till Thursday. I have a brand new spiculated nodule in lower lobe right. And it’s already 13x11mm. I got for a PET tomorrow and I am scared to death. My husband keeps saying I’m overreacting and it could be nothing. I’m a registered nurse and I know this is bad. Am I wrong?

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Being part of the medical community makes us overreact to reports. They could be benign and I can speak from experience, had a PET Scan and the only thing that came back was activity on a new dental crown surgery. The chest nodules were benign and they just keep an eye on them. Big Hugs

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1 reply
darwin66 | @darwin66 | Oct 16, 2023
In reply to @h2opup54 "Being part of the medical community makes us overreact to reports. They could be benign and..." + (show)
@h2opup54

Being part of the medical community makes us overreact to reports. They could be benign and I can speak from experience, had a PET Scan and the only thing that came back was activity on a new dental crown surgery. The chest nodules were benign and they just keep an eye on them. Big Hugs

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That’s great. Was your nodule spiculated aswell?

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darwin66 | @darwin66 | Nov 5, 2023
In reply to @valerie131 "I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In..." + (show)
@valerie131

I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In January I had a CT and it was 7mm so my doctor ordered a follow up ct for in July. I didn’t have it done till Thursday. I have a brand new spiculated nodule in lower lobe right. And it’s already 13x11mm. I got for a PET tomorrow and I am scared to death. My husband keeps saying I’m overreacting and it could be nothing. I’m a registered nurse and I know this is bad. Am I wrong?

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@valerie131 Did you get some answers regarding your nodules?
Hopefully they are nothing to worry about.

REPLY
yulia87 | @yulia87 | Dec 8, 2023
In reply to @valerie131 "No. I’ve never needed one before. Guess it’s time to find one. Thank you. I’m sorry..." + (show)
@valerie131

No. I’ve never needed one before. Guess it’s time to find one. Thank you. I’m sorry you’re going through all of that. You’re one tough cookie. I hope I can be as well.

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Any updates on the nodule?

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marchettia | @marchettia | Jan 31 1:25pm
In reply to @darwin66 "What size was your nodule? Due to the small size of my nodule Biopsy and Petscan..." + (show)
@darwin66

What size was your nodule?
Due to the small size of my nodule Biopsy and Petscan won’t be meaningful.
So doctor suggested the watch and wait approach.
My doctor said that infection, inflammation is a possibility and if it shows any growth on next scan we’ll do surgery.
But given all the data regarding spiculated lung nodules with the up to 90% it’s hard to believe that I will be one of the rare cases where it turns out to be just infection or inflammation..
However the data and studies also mostly refer to nodules that are > 1cm.
Not much information is available on smaller nodules with Spiculation, So I don’t know if the risk of 90% applies to smaller nodules as well?
According to The Fleischner guidelines for smaller nodules with suspicious borders such like Spiculation a follow up in 3-6 Months is recommended.
I think it’s just a matter of time till my nodule grows and is then confirmed malignant and with any growth the possibility of it spreading increases.
Therefore I’m debating whether I should just insist on getting surgery right away to get rid of it as soon as possible.

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I had a spiculated nodule of 1 cm found in my left lower lobe and my doctor also wanted to watch it. It stayed the same size for 1 1/2 years and then doubled in size so he said it was time to get it out. I had my left lower lobe removed 5 years ago. I am so used to it being gone it causes me no issues. My bloodwork indicated I did not need chemo or radiation. I feel thankful for that.
Marchettia in AL

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2 replies
darwin66 | @darwin66 | Feb 1 12:55pm
In reply to @marchettia "I had a spiculated nodule of 1 cm found in my left lower lobe and my..." + (show)
@marchettia

I had a spiculated nodule of 1 cm found in my left lower lobe and my doctor also wanted to watch it. It stayed the same size for 1 1/2 years and then doubled in size so he said it was time to get it out. I had my left lower lobe removed 5 years ago. I am so used to it being gone it causes me no issues. My bloodwork indicated I did not need chemo or radiation. I feel thankful for that.
Marchettia in AL

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Thanks for sharing. Was your nodule solid or non-solid?
And was it caught at stage 1 when you had it removed?

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1 reply
363 | @363 | Feb 2 11:01am
In reply to @marchettia "I had a spiculated nodule of 1 cm found in my left lower lobe and my..." + (show)
@marchettia

I had a spiculated nodule of 1 cm found in my left lower lobe and my doctor also wanted to watch it. It stayed the same size for 1 1/2 years and then doubled in size so he said it was time to get it out. I had my left lower lobe removed 5 years ago. I am so used to it being gone it causes me no issues. My bloodwork indicated I did not need chemo or radiation. I feel thankful for that.
Marchettia in AL

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I am so happy it all turned out well for you..With removing the lobe was your breathing effected? Knowing you blood work turned out well for no chemo or radiation was it confirmed it was indeed cancer or benign. Did you have a biopsy before having the lobe removed..Thank you as I am awaiting a follow up for a nodule in my middle lobe which is too difficult to get at for biopsy and so to have a lobe removed on the possible chance is somewhat concerning..It was 9mm at my last CT 7 months ago..Kind regards

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1 reply
marchettia | @marchettia | Feb 3 9:13am
In reply to @363 "I am so happy it all turned out well for you..With removing the lobe was your..." + (show)
@363

I am so happy it all turned out well for you..With removing the lobe was your breathing effected? Knowing you blood work turned out well for no chemo or radiation was it confirmed it was indeed cancer or benign. Did you have a biopsy before having the lobe removed..Thank you as I am awaiting a follow up for a nodule in my middle lobe which is too difficult to get at for biopsy and so to have a lobe removed on the possible chance is somewhat concerning..It was 9mm at my last CT 7 months ago..Kind regards

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2-3-24

I felt only a little difference in my breathing in the beginning. Now it is no issue. It is just normal to me. Hardly ever even notice it. Yes, my nodule was adenocarcinoma which is a malignant cancer. It is the most common lung cancer they are seeing today in nonsmokers. Had no biopsy because it would be difficult to get to the right spot.

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2 replies
marchettia | @marchettia | Feb 3 9:27am
In reply to @darwin66 "Thanks for sharing. Was your nodule solid or non-solid? And was it caught at stage 1..." + (show)
@darwin66

Thanks for sharing. Was your nodule solid or non-solid?
And was it caught at stage 1 when you had it removed?

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It was stage 1, but I don't recall them saying anything about solid or non-solid.

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