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.

the Biodesix blood test came back indeterminate. Pulmonologist says can't have biopsy, " it will kill you". But says if it shows growth he will refer me to a cardio thoracic surgeon. I'm due for next scan, my seventh, in two months, watching for growth. He mentioned open-heart surgery as only way if growth and if I will need biopsy or surgery. actually he doesn't know how this could successfully be excised or biopsied if needed.
Description of nodule is 14-17mm. It is irregularly shaped, its been described by different radiologists as, a nodule, a consolidation, suggestive of mucous plug, it is non calcified. It doubled in size in a month now seems stable ( may even have lost volume) it is located at base of RML on surface of pericardium. I am asymptomatic. Im hoping the next scan , which will be six months from last one, will show it well on its way to being completely resolved since it is non calcified and may be losing volume. I take supplements in an attempt to self medicate, makes me think i am active in my cure. i'm not panicked (kinda in denial) nor elated yet. ill report what next scan reveals. I feel pretty positive that I'll have good news. Im interested and have a strong desire to share my plight, so thank you all for listening, it helps, a lot.
Hoping all can find peace, horrible feelings of stress need to be respected and treated too. if any want to talk, I'll be glad to listen.

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@linpvc

the Biodesix blood test came back indeterminate. Pulmonologist says can't have biopsy, " it will kill you". But says if it shows growth he will refer me to a cardio thoracic surgeon. I'm due for next scan, my seventh, in two months, watching for growth. He mentioned open-heart surgery as only way if growth and if I will need biopsy or surgery. actually he doesn't know how this could successfully be excised or biopsied if needed.
Description of nodule is 14-17mm. It is irregularly shaped, its been described by different radiologists as, a nodule, a consolidation, suggestive of mucous plug, it is non calcified. It doubled in size in a month now seems stable ( may even have lost volume) it is located at base of RML on surface of pericardium. I am asymptomatic. Im hoping the next scan , which will be six months from last one, will show it well on its way to being completely resolved since it is non calcified and may be losing volume. I take supplements in an attempt to self medicate, makes me think i am active in my cure. i'm not panicked (kinda in denial) nor elated yet. ill report what next scan reveals. I feel pretty positive that I'll have good news. Im interested and have a strong desire to share my plight, so thank you all for listening, it helps, a lot.
Hoping all can find peace, horrible feelings of stress need to be respected and treated too. if any want to talk, I'll be glad to listen.

Jump to this post

Thank you. Patience is always good😃

Sent from Yahoo Mail for iPhone

REPLY
@linpvc

the Biodesix blood test came back indeterminate. Pulmonologist says can't have biopsy, " it will kill you". But says if it shows growth he will refer me to a cardio thoracic surgeon. I'm due for next scan, my seventh, in two months, watching for growth. He mentioned open-heart surgery as only way if growth and if I will need biopsy or surgery. actually he doesn't know how this could successfully be excised or biopsied if needed.
Description of nodule is 14-17mm. It is irregularly shaped, its been described by different radiologists as, a nodule, a consolidation, suggestive of mucous plug, it is non calcified. It doubled in size in a month now seems stable ( may even have lost volume) it is located at base of RML on surface of pericardium. I am asymptomatic. Im hoping the next scan , which will be six months from last one, will show it well on its way to being completely resolved since it is non calcified and may be losing volume. I take supplements in an attempt to self medicate, makes me think i am active in my cure. i'm not panicked (kinda in denial) nor elated yet. ill report what next scan reveals. I feel pretty positive that I'll have good news. Im interested and have a strong desire to share my plight, so thank you all for listening, it helps, a lot.
Hoping all can find peace, horrible feelings of stress need to be respected and treated too. if any want to talk, I'll be glad to listen.

Jump to this post

@linpvc , 'Indeterminate' is an interesting place. At least it wasn't definitely cancer, but on the other hand it would be nice to have answers, and ultimately some sense of control. If it helps, most of us with a cancer diagnosis also experience the cycle of scans and waiting, scans and waiting. It seems that you've been able to stay positive about the situation. That should help!
Please stick around and keep us posted on how things are going.

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@lls8000

@linpvc , 'Indeterminate' is an interesting place. At least it wasn't definitely cancer, but on the other hand it would be nice to have answers, and ultimately some sense of control. If it helps, most of us with a cancer diagnosis also experience the cycle of scans and waiting, scans and waiting. It seems that you've been able to stay positive about the situation. That should help!
Please stick around and keep us posted on how things are going.

Jump to this post

Thank you, I’ll do that. Thank you for the response.

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I have a 1 cm spiculated nodule in right upper lobe
They did a bronchoscopy 7-22-24 came back benign. Had my 3 month check up November 3, still has not changed.
Keep the faith!

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Is your spiculated nodule stoll benign?

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Several times in the past 10 years my CT scans have shown numerous spiculated nodules/tumors.
With a few Docs themselves were almost certain they were malignant. Each time biopsies were taken it was infections causing the mimicking of cancer.

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Thank you for posting this very important information. Did the nodules disappear and new ones pop up or did they just stay stable and continue to show up on the CT scan...I am thrilled for you they were only mimicking cancer...

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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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Hello kiducator, I just wanted to check in to see if you were able to get your nodule biopsied and what the result was? I too have nodules we are watching around the same size yours was and I am currently in the "surveillance mode" waiting for repeat scans to see if anything changes. I find it maddening to know something is in there that shouldn't be there and that they can't tell us more about it without taking it out. Could be something bad, could be nothing to worry about but still in there. I hope you are doing well and you have gotten some answers! Wishing you good health!

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Hello everyone, my name is Melisa and I came to this forum tirelessly searching for an answer that would ease my heart. I am 32 years old and I am my mother's only daughter, who is the reason and meaning of my life. He is 62 years old and in a lung CA scan due to smoking for many years, a 17mmx17mm solid subpleural nodule with irregular and spiculated margins, with a tendency to crash, was detected in the right upper lobe, anterior segment. All doctors have a proactive and aggressive approach and I understand why, but I can't understand why us. I don't want my mom to suffer, I don't want her to feel pain, I couldn't lose her, it would be losing myself because she is the reason for my life, I don't have anyone else. I try to be strong for her and try to pay attention to her or do things together that we enjoy, but since last week we were told this, our life has changed.
I am following up with my psychologist and my psychiatrist, she too, I have left my job for now, and I would really like to know if there is any minimal possibility or any case in the literature or medical practice that an injury of these characteristics could have a benign etiology? I look for the infiltration pattern, the reason for the spiculation, but everything the books or the internet say are cheap shots. Perhaps it is important to note that she underwent open surgery for achalasia when she was 20 years old and there was a significant decrease in esophageal motility, which is why she sometimes regurgitates and chokes frequently at night. In any case, doctors have told me that aspiration pneumonia does not have this type of presentation. I look for hamartomas, granulomas, some other etiology, but nothing, absolutely nothing seems to indicate another origin that is not malignant, taking into account the entire context. Could someone help me?In Argentina times are tyrannical. We have an appointment with the pulmonologist next week, who will send you the PET CT. Then we will try to get it authorized through our social work as quickly as possible, we do not have the resources to pay for it. Once this is done, they do not tell us what is diagnostic or specific, but rather they will move forward with the operation, probably on the segment. We don't know what the extent of this may be. I'm afraid it's an advanced stage. I have never felt anything like this in my life. I can't lose her. I couldn't bear to see her suffer although I must be strong for her, as she always was for me. I couldn't explain to you what a wonderful woman she is. Could anyone help me with their experience? I thank God for having come to this forum.
Please, help.

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