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 ?

Interested in more discussions like this? Go to the Lung Health Support Group.

363 | @363 | Oct 13 11:35am
In reply to @linpvc "Im going through the same as you. mine is on surface of pericardium . It is..." + (show)
@linpvc

Im going through the same as you. mine is on surface of pericardium . It is now stable, non calcified and spiculated. More scans for awhile until it resolves or grows
I hope yours turns out to be benign. Boy these nodules sure cause a disruption.
wishing you well.

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Sorry to hear that yours too cannot be biopsied...and it is disruptive for sure...I live in Canada so the blood test by Biodex called Nodify XL2 is not available here yet but is in the US...are you able to get this test as it seems results are pretty accurate with just a draw of blood .
Wishing you well also..

REPLY
frankie160 | @frankie160 | Oct 14 9:41am

Hi Darwin66,
Your concerns and your clear layout of your condition motivated me to
dig in on the research as you did which I have just begun. I also have a condition which I'm calling MPN.....MultiplePulmonaryNodules......
In my case a PET Scan taken in 2022 lit up like a Christmas Tree causing
me stress, however only to find out that many of the nodules were
"mucous balls". I also had at the time BE/NTM Avium Complex.
My doc indicated that I would be followed annually with a CT Scan to keep an eye on the nodules and my condition I felt OK about this but may want to learn more about the size of my nodules and begin to advocate for more follow-up. We will continue to learn more and be ready to advocate for ourselves.
Thank you for your post.
Flo@Frankie160

REPLY
maven1 | @maven1 | Nov 1 9:54am
In reply to @vic83 "I applaud your research efforts. I think the "up to 90%" comment tells the story. I..." + (show)
@vic83

I applaud your research efforts. I think the "up to 90%" comment tells the story. I had nodule (RUL) removed sixteen months ago. It was spiculated, and it was malignant (stage 1b). The wording on the CT scan can be informative. My first CT scan noted it was spiculated and said it could be cancer, scarring or something else. (I had quit smoking 20 years before). The CT scan suggested a PET scan and the PET scan "lite up" in two areas. I had biggest nodule removed 16 months ago and now about to remove the other.
I have multifocal lung cancer so have other nodules that are considered cancer and they wait until they get to a certain size before treating. They want to preserve lung tissue. They monitor nodules with CT scans but also check them with PET scan which tells a lot.
If you have any doubts, seek a second opinion. I did. Look for Pulmonologist with specific focus in lung cancer.

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Question? There isn’t chemo or radiation following, is there??

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1 reply
vic83 | @vic83 | Nov 1 10:52am
In reply to @maven1 "Question? There isn’t chemo or radiation following, is there??" + (show)
@maven1

Question? There isn’t chemo or radiation following, is there??

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Treatment type depends on various factors such as location, stage etc.
In my case I have multifocal lung cancer (I have multiple nodules that are considered primary cancers and not metastasis), and my PET scan was clean so I did not need chemo after surgery. I then had a second surgery (always wedge resection) after a year in a different lung. I then had SBRT on two different nodules. I now have another nodule that is indeterminate so I wait to see what happens.

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1 reply
maven1 | @maven1 | Nov 1 11:01am
In reply to @vic83 "Treatment type depends on various factors such as location, stage etc. In my case I have..." + (show)
@vic83

Treatment type depends on various factors such as location, stage etc.
In my case I have multifocal lung cancer (I have multiple nodules that are considered primary cancers and not metastasis), and my PET scan was clean so I did not need chemo after surgery. I then had a second surgery (always wedge resection) after a year in a different lung. I then had SBRT on two different nodules. I now have another nodule that is indeterminate so I wait to see what happens.

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Thank you so much! Best to you!

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bigmamamw | @bigmamamw | Nov 1 5:58pm
In reply to @sallik74 "I too had a spiculated nodule upper right lobe Had bronchoscopy came back benign" + (show)
@sallik74

I too had a spiculated nodule upper right lobe
Had bronchoscopy came back benign

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What size was your lesion/nodule? I have just been told that I have a 2.2 cm one in upper left lung.

REPLY
2 replies
bigmamamw | @bigmamamw | Nov 1 6:01pm
In reply to @breathe57 "I have a spiculated growth. In three months it hasn't grown. I guess we don't need..." + (show)
@breathe57

I have a spiculated growth. In three months it hasn't grown. I guess we don't need to worry too much, yet. Good to catch them early. Hugs to you.

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What size was your nodule?

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sallik74 | @sallik74 | Nov 1 8:27pm
In reply to @bigmamamw "What size was your lesion/nodule? I have just been told that I have a 2.2 cm..." + (show)
@bigmamamw

What size was your lesion/nodule? I have just been told that I have a 2.2 cm one in upper left lung.

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1.2 cm x 1 cm
Right upper lobe
It should be fine. They will just monitor every 3 months.
Are you going to have a bronchoscopy?

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Mentor
Lisa, Volunteer Mentor | @lls8000 | Nov 7 12:13pm
In reply to @bigmamamw "What size was your lesion/nodule? I have just been told that I have a 2.2 cm..." + (show)
@bigmamamw

What size was your lesion/nodule? I have just been told that I have a 2.2 cm one in upper left lung.

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Welcome to Mayo Connect @bigmamamw. Sorry to hear that you are having to deal with a nodule. Has your doctor provided you with next steps? Is it in a location that can be biopsied? Have you been ill recently?

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