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Is a Spiculated lung nodule always malignant?

Lung Health | Last Active: Nov 7 12:13pm | Replies (129)

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@kiducator

I see your comment about a non cancerous lung nodule that was fungal. I am not sure what is in my lungs. I know there are nodules, scarring, and large lymph nodes of concern. I went to the surgeon my oncologist sent me to, so he could do a biopsy and see for sure what has been causing me problems. By looking at my CT scan and the report he felt very positive it was cancer and should come out. It is 1.3 X 1.4 cm which is 13-14 mm and doesn't sound like a huge mass. There was another nodule he was not sure about. I thought the PET and biopsy was done before any discussion of removing cancer and margins. But I realize when I said "how soon can you remove it ?" he thought OK she is ready to have it gone schedule some surgery for this woman.

The nurse told me that sometimes if it is small and they go in to do a biopsy it is just as easy to take it out at that time. Which kind of makes sense. I am surprised he didn't tell me to hold my horses that we need to do a PET scan first. I have nodules on my thyroid also. They were going to do a needle biopsy on it at the end of the month. I am hoping if it comes up on the PET that I will have a little more of an idea if it is something to be concerned about. My thinking was also lets do the PET scan so I know exactly what I am looking at. One radiologist commented on "multiple additional smaller sub-centimeter pulmonary nodules concerning for pulmonary metastases in both lower lobes". So I want to know going in if they are mets or not. I have been told I have scarring in my lungs and I am hoping that is what is at the bottom of my lungs. I am wondering if many people have to request a PET scan or if the doctor recommends one along with a biopsy to make a plan before he starts cutting on me.

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Replies to "I see your comment about a non cancerous lung nodule that was fungal. I am not..."

Welcome to Mayo Connect @kiducator. This is a scary time for you, your feelings and questions are all valid, and most of us have been in your shoes. It sounds like you have some experience with lung complications and doctors, listen to your instincts, they will guide you well. Many people have the first instinct of 'get it out', but unless you are in an emergency room, there is time to make some thoughtful decisions. All decisions come with risks, and those need to be carefully weighed.
Our lungs can react to foreign substances in many ways. We can rarely say 'always' when talking about our health or lungs, so I would say that spiculated nodules are not always malignant. The spiculation can be a sign that may lean toward cancer, but always isn't a word that I would use.
Radiologists are accessing what they see on the scan, and yours are recommending further investigation. Without a pathology report from a biopsy or surgical sample, no one can be 100% sure what the nodules are. The PET scan is a great next step.
Once you have the PET results are you able to consult with your Pulmonologist, to see what they may recommend?